by Tim Rowan | Nov 8, 2024 | Clinical, CMS, Editorial, Medicare Advantage, Regulatory
by Tim Rowan, Editor Emeritus OIG Accuses Medicare Advantage Providers of Padding Patient Assessments...Again “Hello, this is your Medicare Advantage company calling. I am one of their clinicians and it is time for us to update your health assessment. If you...
by Elizabeth E. Hogue, Esq. | Oct 31, 2024 | Clinical, Regulatory
by Elizabeth E. Hogue, Esq. Everyone in the "Fraud Soup" Together Perhaps you remember the CEO of a hospice in the Dallas area, Novus Health Care Services, who texted staff members urging them to administer drugs to patients to avoid exceeding per patient spending...
by Elizabeth E. Hogue, Esq. | Sep 20, 2024 | Admin, Regulatory
by Elizabeth E. Hogue, Esq. Bring on the Fraud Enforcers We Have Nothing to Hide! Oh, but you do! Statements like this from providers are cringe-worthy. If you have said it before, please don’t ever say it again. Here’s why: First, many providers think that when fraud...
by Kristin Rowan | Sep 12, 2024 | Admin, CMS, Hospice, Regulatory
by Kristin Rowan, Editor CMS Oversight in Fraud-Ridden States In 2023, The Centers for Medicare and Medicaid Services (CMS) cited research suggesting that hospices profit from fraud far too often. CMS has identified cases of hospices certifying benficiaries who are...
by Elizabeth E. Hogue, Esq. | Apr 18, 2024 | Clinical, Regulatory
by Elizabeth E. Hogue, Esq. Some owners and managers of private duty home care agencies mistakenly think that fraud and abuse prohibitions apply only to services paid for by the Medicare Program. In fact, fraud and abuse prohibitions apply to providers if they accept...
by Elizabeth E. Hogue, Esq. | Feb 14, 2024 | Admin
by Elizabeth E. Hogue, Esq. Two former Amedisys employees claim that they were fired in retaliation for alerting management to possible violations of the federal False Claims Act. They then filed a whistleblower, or qui tam, lawsuit [Pilat v. Amedisys, Inc., No....
by Elizabeth E. Hogue, Esq. | Jan 31, 2024 | Admin, Regulatory
by Elizabeth E Hogue, Esq. Providers may have heard or read about the importance of Fraud and Abuse Compliance Plans in their organizations. Despite the wealth of available information about Compliance Plans, many providers continue to express uncertainty about their...
