Lifewatch Services, Inc., an Illinois-based company, recently agreed to pay the United States $18.5 Million to resolve False Claims Act allegations filed by two separate whistleblowers. In addition to the settlement, Lifewatch entered into a comprehensive Corporate Integrity Agreement with the Office of Inspector General.
The whistleblower complaints alleged that Lifewatch improperly billed Medicare for ambulatory cardiac telemetry (“ACT”) services. Continue reading
In recent years, home health agencies (“HHAs”) have been under a tremendous amount of scrutiny due to perceived concerns involving fraud and abuse. To that end, CMS assigned newly enrolling HHAs to the high-risk screening level in 2011, and the OIG responded by significantly increasing its focus on HHAs, as evidenced by the numerous OIG initiatives targeting HHAs contained within the OIG’s 2012 Work Plan. Many news outlets have also been critical of HHAs, particularly with respect to compliance with Medicare coverage requirements.
In a new report (the “Report”) issued by the OIG in March of 2011, however, the OIG released data which indicates that HHAs are doing a fairly good job in complying with Medicare coverage requirements. Continue reading
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Posted in Community Based Care, Fraud and Abuse, Health Care, Health Care Providers, Home Health, Medicare, OIG, Participation, Program Integrity, Regulatory Compliance, Reimbursement
As part of CMS’ continued efforts to implement the provisions of the Patient Protection and Affordable Care Act, CMS proposed a new rule on February 16, 2012 (the “Proposed Rule”) that will require providers to report and return self-identified overpayments by the later of: (1) the date which is 60 days after the date when the incorrect payment was identified; or (2) the date any corresponding cost report is due, if applicable. Failure to report and return an overpayment within 60 days could result in a violation of the False Claims Act, civil monetary penalties, or exclusion from participation in Federal health care programs. Continue reading
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Posted in Compliance Programs, Fraud and Abuse, Health Care, Health Care Providers, Health Reform, Medicaid, Medicare, Program Integrity, Proposed Rule, Regulation, Regulatory Compliance
In 2009, House Bill 1 amended the Ohio Certificate of Need (“CON”) laws to permit inter-county relocations of long-term care beds under certain circumstances. Historically, Ohio CON laws prohibited relocating long-term care beds across county lines. Despite this amendment, the process to accomplish an inter-county relocation of beds remains heavily regulated, and in most cases must be commenced during brief windows of time set forth by the Ohio Department of Health. Continue reading
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Posted in Certificate of Need, Continuing Care, Health Care, Health Care Providers, Long Term Care, Nursing Facility, Nursing Home, Ohio, Post Acute Care, Regulation, Rehabilitation, Skilled Nursing Facility
Benesch
Ari J. Markenson, JD, MPH
Janet K. Feldkamp RN BSN LNHA CHC JD
Robert W. Markette, Jr. CHC
W. Clifford Mull
Frank W. Carsonie
Daniel J. O'Brien
Benjamin J. Parsons
Meredith L. Rosenbeck
Alan E. Schabes
