The U.S. Department of Labor (DOL) has sued Advanced Care Staffing (ACS), a New York staffing agency that, among other activities, recruits registered nurses from the Philippines to work in U.S. nursing homes, charging the company and its CEO with … [Read more...] about Immigrant Nurses – Be Wary of Staffing Agencies that Violate Federal Law
Weekly Alert
MIPPA Still not Funded, Threatening Resources
Currently, Congress has not authorized and provided funding for Medicare Improvements for Patients and Providers Act (MIPPA) low-income outreach and assistance programs, which will significantly hamper State Health Insurance Assistance Programs … [Read more...] about MIPPA Still not Funded, Threatening Resources
Know Jimmo | When It’s Known, It Works
"My 92-year-old mother finally received payment this week related to her Second Level Appeal win against United Healthcare that was done by Livanta…my mother has now won 3 Medicare Appeals related to denial of skilled services received at a rehab/ … [Read more...] about Know Jimmo | When It’s Known, It Works
Advocates Send Letter Regarding Misleading MA Advertising
Today the Center for Medicare Advocacy, along with the National Health Law Program, the National Disability Rights Network and Disability Rights CT, sent a letter to the Centers for Medicare & Medicaid Services (CMS) as well as the Federal Trade … [Read more...] about Advocates Send Letter Regarding Misleading MA Advertising
CMS Issues Final Rule on Nursing Home Transparency
The Centers for Medicare & Medicaid Services (CMS) issued final rules on disclosure of ownership of nursing facilities participating in the Medicare and Medicaid programs, as required by §6101(a) of the Affordable Care Act, 88 Fed. Reg. 80141 … [Read more...] about CMS Issues Final Rule on Nursing Home Transparency
Know Jimmo – CMS Reminded Providers & Contractors in 2021
“Skilled Nursing Care & Skilled Therapy Services to Maintain Function Or Prevent or Slow Decline: ReminderMedicare covers skilled nursing care and skilled therapy services under skilled nursing facility, home health, and outpatient … [Read more...] about Know Jimmo – CMS Reminded Providers & Contractors in 2021
New Substance Use Disorder Coverage in Medicare in 2024
Guest article by Deb Steinberg, Senior Health Policy Attorney, Legal Action CenterOn November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) released its Physician Fee Schedule (PFS) and Outpatient Prospective Payment System … [Read more...] about New Substance Use Disorder Coverage in Medicare in 2024
STAT News Report Further Exposes Medicare Advantage Misconduct Concerning Prior Authorization Using Restrictive Algorithmic Tools
The latest in a series of articles, STAT News recently issued a report titled “UnitedHealth pushed employees to follow an algorithm to cut off Medicare patients’ rehab care” by Casey Ross and Bob Herman (Nov. 14, 2023). The report found that ‘[t]he … [Read more...] about STAT News Report Further Exposes Medicare Advantage Misconduct Concerning Prior Authorization Using Restrictive Algorithmic Tools
Know Jimmo | Medicare Law and CMS Policy Spell It Out
The Code of Federal Regulations:“Restoration potential is not the deciding factor in determining whether skilled care is required. Even if full recovery or medical improvement is not possible, a patient may need skilled services to prevent … [Read more...] about Know Jimmo | Medicare Law and CMS Policy Spell It Out
Center Comments on Proposed Rule to Discourage Discrimination in Federal Programs
The Center for Medicare Advocacy submitted comments this week in response on a proposed rule updating Section 504 of the Rehabilitation Act of 1973 in order to protect against discrimination on the basis of disability in HHS-funded programs. The … [Read more...] about Center Comments on Proposed Rule to Discourage Discrimination in Federal Programs