As providers of Medicare services, nursing homes rely heavily on the timely and accurate reimbursement from the government to ensure the provision of top-quality care to their residents. The negative financial implicatio...
CMS’ Home Care Compare Website to Display Disputed Survey Citations Prior to Resolution
March 14, 2023
CMS issued a memorandum regarding changes to the Nursing Home Care Compare website. Of particular note for home care facilities is the posting of preliminary survey findings of nursing facilities prior to final resolutio...
More CCO Skin in the Game Moving Forward
March 2, 2023
Chief Compliance Officers (CCOs) routinely take point on reaching resolution with state and federal regulators when addressing and settling cases related to regulatory or compliance violations. However, in 2022, the US D...
OIG’s Evolving Integrity Agreements
February 22, 2023
Recently, the OIG modified the provisions and requirements of several corporate integrity agreements (CIA). In addition to having direct impact on those organizations subject to such agreements, these changes also provid...
Updated Guidance on Exclusion Screening for New Jersey’s Medicaid Providers and Plans
February 15, 2023
In January of 2023, New Jersey issued new guidance regarding those databases that healthcare entities (including providers and managed care organizations) participating in NJ’s Medicaid program must query monthly to ve...
Recent Additions to California’s Medi-Cal Exclusion Screening Databases
December 7, 2022
The California Medicaid program, known as Medi-Cal, is a highly regulated program by any measure. California takes a very intensive approach to assure that organizations offering services to Medicaid recipients meet a ve...
Data Analytics and Collaboration Drive Continued Success for Texas HHS-OIG
November 22, 2022
The 2022 Quarter Four Fiscal Report of the Texas Health and Human Services OIG was issued in September 2022 with highlights from another very successful year. The report reflects the continued focus of the OIG on enhance...
Deficit Reduction Act Compliance: Certification Requirements for New Jersey Providers & MCOs
November 9, 2022
Background on the DRA The federal Deficit Reduction Act of 2005 (DRA) included new requirements related to fraud, waste and abuse for Medicaid plans that received or made payments of $5 million dollars or more in any ...
Fun and Smart Ways to Celebrate Compliance & Ethics Week
October 3, 2022
Adhering to compliance standards protects all consumers of healthcare services and ultimately enables the delivery of the highest levels of healthcare across the country. An annual Compliance Week provides a great opport...
