Health plans considering Medicare Advantage or Medicaid as a new line of business need to be well informed of the greatly enhanced oversight and requirements they will face compared to state regulation of commercial plan...
2021 Audit Alert: Background Checks for Nursing Home Employees
February 22, 2021
In January of 2021 Centers for Medicare and Medicaid Services (CMS) announced that they would be auditing compliance with the National Background Check Program for Long-Term Care Providers. The National Background Check ...
CMS Preclusion vs OIG Exclusion
February 8, 2021
On January 1, 2019, the Centers for Medicare & Medicaid Services (CMS) introduced a new tool for Medicare plans – the CMS Preclusion List. A previous article posted in 2018 provides an excellent overview of t...
COVID-19 Health Care Changes that May Survive the Pandemic
January 4, 2021
The COVID-19 pandemic has changed the face of the health care industry on multiple fronts. These range from the multiple blanket 1135 temporary waivers issued by CMS that control how care for federal program beneficiarie...
Survey and Accreditation Activities in the Age of COVID-19
December 21, 2020
As the first vaccines are delivered across the US, we can begin to look forward to a post-pandemic future and resuming routine activities that have been sharply curtailed in 2020. This includes the resumption of the fu...
Pandemic-Related Waivers by CMS and the Continued Importance of monitoring OIG Exclusion Lists
December 14, 2020
COVID 19 has resulted in a flurry of waivers by federal and state regulatory agencies related to the provision of health care for Medicare and Medicaid patients. The CMS blanket waivers (issued as “1135 waivers” unde...
Two OIG Reports Encourage More Vigilance about Providers’ Medicaid Eligibility
April 27, 2020
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