Medicare Compliance & Reimbursement
FOR NURSING HOMES, QUALITY IS JOB ONE
Nursing homes that fail to establish solid programs to ensure quality of care could very well end up having such programs imposed on them. As state and federal prosecution of "failure of care" cases heats up, nursing homes are more and more often compelled, as a condition of settling the cases, to implement aggressive quality-oriented compliance programs. In one recent example, a Hobbs, NM nursing home entered into such an agreement with the New Mexico attorney general's office. AG Patricia Madrid says Country Cottage Care and Rehabilitative Center failed to provide services that met minimum quality standards, and improperly collected Medicaid payments for the inadequate care. In settling the case, the nursing home will pay $25,000 back to the Medicaid program. But that's not the meat of the settlement. To resolve the AG's case, Country Cottage also agreed to a two-year quality agreement designed to ensure better training for caregivers, nurses and food services workers; improved safety for patients who wander; and better medical oversight. Lesson Learned: The nexus between Medicare and Medicaid compliance and quality of care is growing ever tighter, so compliance officers should be attuned to the level of care being offered at their facilities.
Medicare Compliance & Reimbursement
- Legislation:
MEDICAID CUTS HANG IN THE BALANCE
The House and Senate are duking it out over $93 billion in Medicaid cuts, and [...] - Quality Improvement:
NEWSPAPER ADS COMPARING HHA OUTCOMES WEEKS AWAY
The Centers for Medicare & Medicaid Services will trumpet home health agency patient outcomes in [...] - Pharmaceuticals:
COURT OKS MICHIGAN MEDICAID RX PROGRAM
Michigan may go forward with its effort to obtain deep discounts from prescription-drug manufacturers for [...] - Medicare+Choice:
MOST POPULAR M+C PLANS TO GET TWO PERCENT RAISE
In 2004, managed care plans serving the majority of Medicare+Choice beneficiaries will again see only [...] - Compliance:
HEALTH CARE DIRECTORS MUST SPEAK UP ON COMPLIANCE
As the Enron fiasco continues to play out and the HealthSouth debacle puts the corporate [...] - Medicare:
MEDICARE REGULATORY REFORM MOVES FORWARD, BUT HALTINGLY
It's nice to know that even in the House Ways and Means Committee, occasionally a [...] - Self-Referral:
STARK LAWS COULD CAST WIDER NET
Specialty hospitals will be in for a major overhaul of how they structure deals with [...] - Quality of Care:
FOR NURSING HOMES, QUALITY IS JOB ONE
Nursing homes that fail to establish solid programs to ensure quality of care could very [...] - Physicians:
STAFFING COMPANIES IN LINE FOR STEPPED UP SCRUTINY
Staffing companies that contract with physicians to staff emergency rooms and other hospital departments could [...] - HIPAA:
PROVIDERS ADOPT 'JUST-IN-TIME' APPROACH TO HIPAA COMPLIANCE
Have you deferred a good chunk of your Health Insurance Portability and Accountability Act compliance [...] - Medicaid:
SCHOOL-BASED SERVICES DRAW FRAUD-FIGHTERS' NOTICE
Medicaid rules and regulations cast a wide net, and sometimes the fraud and abuse perils [...] - Reimbursement:
NEW APPROACHES TO NEW TECH PAYMENTS
Health care providers that deal extensively with new and emerging technologies may soon see some [...] - Medicaid:
AUDIOLOGISTS FACE NEW RULES FOR MEDICAID
Audiologists would have to meet a new set of requirements to provide services - including [...] - Medicare+Choice:
FINAL M+C APPEAL RULE EASES ADVANCE NOTICE REQUIREMENT
Medicare+Choice organizations will have to notify enrollees two days prior to terminating services under a [...] - PROGRAM MEMO ROUNDUP
Health care providers that bill Medicare for Part B mental health services should take special [...] - BILL WATCH
The following House bills were introduced:
H.R. 1539. A bill to amend title XVIII of [...]
