Articles and Blogs

certification

Sixth Circuit Rejects HITECH FCA Complaint

[03/14/16]

Posted on March 14, 2016 in False Claims Act Defense

Written by: David B. Honig

The Sixth Circuit Court of Appeals, in US ex rel. Sheldon v. Kettering Health Network, affirmed the dismissal of a False Claims Act (“FCA”) suit alleging fraud based upon certifications of compliance with the HITECH Act and a data breach. The HITECH Act, or Health Information Technology for Economic and Clinical Health Act, encourages the... READ MORE

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OIG Publishes 2013 Work Plan

[10/05/12]

Posted on October 5, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

The Office of the Inspector General (OIG) has published their annual Work Plan for 2013. The Work Plan continues to identify compliance risk areas that subject Medicare and Medicaid providers to audit and enforcement initiatives. The Work Plan specifically targets skilled nursing facilities (SNFs), hospices, and home health agencies (HHAs). For all types of... READ MORE

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Physician Assistants Now Permitted to Perform SNF-Level Certifications, Recertifications

[01/21/12]

Posted on January 21, 2012 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

This week, the Centers for Medicare & Medicaid Services (CMS) updated Section 40.1 of Publication 100-1, the Medicare General Information, Eligibility and Entitlement Manual, to reflect Section 3108 of the Patient Protection and Affordable Care Act (PPACA).  This update permits physician assistants to perform the initial certifications and recertifications of a beneficiary’s need for skilled... READ MORE

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CMS Updates Claims Processing Manual to Reflect Failure of Timely Hospice Face-to-Face

[10/11/11]

Posted on October 11, 2011 in Long-Term Care, Home Health & Hospice

Written by: Bufford, David W.

As previously discussed, hospice providers are required to have a hospice physician or nurse practitioner perform a face-to-face encounter with each hospice patient whose total length of stay is anticipated to reach the third benefit period.  This encounter must be performed no more than thirty days prior to the third benefit period recertification, and... READ MORE

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CMS Guidance on Use of Video Cameras in ICFs/MR

[08/16/11]

Posted on August 16, 2011 in Long-Term Care, Home Health & Hospice

Written by: Selby, Todd J.

On July 29, 2011, CMS issued the following guidance for the use of video cameras in ICFs/MR: To ensure that clients’ rights are protected, the use of video cameras in the ICF/MR must be reviewed, approved and monitored by the Specially Constituted Committee (SCC) of the facility as constituted per 42 CFR 483.440(f)(3)(i-iii).  If... READ MORE

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