Imagine the following scenario (this is based on a true story, but no names have been mentioned for a reason….I like the mystery!) No seriously, this happens with some regularity. You are a medical worker at a HIPAA covered entity (say a doctor’s office). You use...
On October 25, 2018, the Kaiser Family Foundation issued a report entitled “States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019.” A copy of the full report can be accessed here. ...
It usually starts with a telephone call from your friendly state Medicaid Fraud Control Unit (MFCU). The voice on the other end of the phone tells you that they are going to come out and audit your Medicaid billing documents and want to find a...
Every state in the United States, except North Dakota, has a Medicaid Fraud Control Unit (“MFCU”) that’s mission is to investigate and prosecute Medicaid provider fraud and patient abuse, and neglect. MFCUs are a creation of federal statute and receive 75% of their funding for...
If your home care and/or home health agency is located in a state with a well-developed Medicaid waiver program, becoming a provider can help you diversify revenue streams and increase your census. While most states have a waiver program or make home and community based...
In the September 18, 2018 Federal Register, at pages 47246-47275, the Department of Veterans Affairs (VA) announced its final rule regarding, among other things, calculation of income and assets for need-based programs and in-home services to veterans. The VA had proposed to set a nationwide...
Everyone who has contact with the health care system in the United States, whether a provider, a patient, an administrator or a vendor, is aware of the Health Insurance Portability and Accountability Act of 1996, more commonly referred to as HIPAA. There are two primary...
Nurses and medical doctors are the two most trusted and respected professions in America according to a Gallup poll released in December 2018. Those polled were asked to rate the honesty and ethical standards of people in various professional fields. Eighty-four percent of respondents rated...
Do you ever get the feeling that government regulators are not telling you the whole story regarding the standards to which your agency will be held? Have you ever said to yourself, “If only I knew what the regulators and auditors were looking for, I...