Featured Article

The government website is designed to help improve the lives of all Americans. Population health is a relatively new term for most people, even with the healthcare community.  According to David Kindig and Greg Stoddart in their March 2003 article "What is Population Health?" in the American Journal of Public…
Both policy issues remain on the CMS agenda, even though the agency has lost two court battles. Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma was probably well aware of what she was walking into last week at the U.S. House of Representatives Energy and Commerce committee hearing.…
There are resources available to help prevent wrongdoers from successfully targeting vulnerable patient populations. A dirty little secret of the long-term care industry is that the problem of identity theft arises more often than is reported.  In all fraud, there is the fraud triangle. The triangle sides are pressure, opportunity,…
Therapy hours could go down and depression to go up at SNFs. A depression diagnosis is often hard to make. Clinical depression can be demonstrated in many ways and requires the subjective findings of a clinician. Some clinically depressed individuals seem to withdraw, while others can become irritable or even…
October 3, 2019

Medicare Reimbursements Are Your Property Rights

By Knicole C. Emanuel Esq.
As a Medicare/Medicaid healthcare provider, you have a property right to your reimbursements for services rendered that were medically necessary. Why does it matter if your Medicare or Medicaid reimbursements constitute property rights? If you have a property right to something, it cannot be taken from you without due process…
An ad campaign opposing the move is raising eyebrows nationwide. We’re more than halfway into September, but if you’re like me, it feels like 2019 is already over. It doesn’t feel like I’ll have enough time to finish everything I was supposed to before the end of the year. Congress…
The ruling marks a stinging rebuke of HHS efforts to steer some services from the hospital outpatient setting to physicians. A federal judge has ruled that a Centers for Medicare & Medicaid Services (CMS) final rule slashing Medicare payments for certain hospital outpatient clinical evaluation and management (E&M) services to…
September 12, 2019

CMS Tightens Rules Governing Reporting on Affiliated Parties

By Duane Abbey, PhD, CFP
CMS wants to identify bad actors -– even if they are or have been affiliated with a legitimate provider. On Sept. 5, the Centers for Medicare & Medicaid Services (CMS) issued a new final rule. There was not really a proposed rule to which comments and suggestions could be made;…