Category archive: Medicaid

Delays in Illinois Medicaid Approval Under Fire

As every long-term care facility doing business in Illinois can attest, Medicaid eligibility determinations and benefit awards have been slow, with HFS often falling months, if not years, behind. A group of SNFs and their residents are trying to change that. Several healthcare providers and their patients have filed suit against Felicia Norwood in her…

CMS Unveils Websites for Comparing Rehabilitation and Long-Term Care Facilities

The Centers for Medicare & Medicaid Services has unveiled two new websites for consumers that include information comparing rehabilitation facilities and long-term care facilities. CMS says that these websites are optimized for mobile use. The sites are located at medicare.gov/inpatientrehabilitationfacilitycompare/ and medicare.gov/longtermcarehospitalcompare/ By Jonathan W. McCrary

Section 483.15 Admission, Transfer and Discharge Rights

Implementation Date: November 28, 2016¹ Section 483.15 replaces section 483.12 and requires the facility to establish an admissions policy. Section (a)(2) states facilities cannot request or require residents or potential residents to waive their rights to Medicare or Medicaid benefits or any rights conferred by applicable state, federal and local licensing or certification laws. Section(a)(2)(iii)…

CMS Final Rule – Comprehensive Analysis by Sandberg Phoenix LTC Team

Over the next few weeks, the Sandberg Phoenix Long-Term Care and Senior Housing Team will be rolling out its analysis of the new CMS Final Rule revising the requirements that Long-Term Care facilities must meet to participate in the Medicare and Medicaid programs. We will address each revision and how it impacts both the care…

New Final Rule for National Emergency Preparedness for Medicare/Medicaid Providers & Suppliers

Following recent natural disasters, such as Hurricane Sandy or episodes of serious flooding; the Centers for Medicare and Medicaid Services (CMS) published a Final Rule to help Medicaid & Medicare providers and suppliers plan for natural and man-made disasters. The new regulations provide consistent emergency preparedness requirements with a goal of enhancing patient safety during…

Hospital Alert – Medicare Update Mandates the Use of Modifier JW for Billing Discarded Drug Waste

Discarded pharmaceuticals and the high cost of drugs continue to receive attention in the news, as well as from the Centers for Medicare and Medicaid Services (CMS). In response to these concerns, CMS recently issued a mandate updating the use by hospitals of the JW modifier to document discarded drugs or biologicals in patient’s medical…

Anti-Kickback Update – HHS-OIG Settles Ambulance Swapping Case $3 Million Settlement from Nursing Home in Ambulance Swapping Case

Demonstrating the government’s commitment to combat health care fraud and keeping providers accountable, the U.S. Attorney’s office of Southern District announced that Regent Management Services L.P., a long term provider, agreed to pay approximately $3.199 Million to settle allegations that it received kickbacks from ambulance companies for referrals of Regent’s Medicare and Medicaid patients needing…

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This information is not intended to create, and receipt or viewing does not constitute, an attorney-client relationship. © 2014 Sandberg Phoenix & von Gontard P.C. All Rights Reserved.

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