With agencies dueling to regulate nursing homes, aligning priorities for a strategic compliance program may be more challenging than ever.

While providers aren’t required to follow OIG recommendations, a compliance program based on their guidance can spare facilities future headaches, since ...

Angela Palo is COO of Pinnacle Financial Services, a leading National Medicare Brokerage, and member of the NABIP Medicare FMO Council. For several years, I was the compliance officer at my agency. It ...

Editor’s Note: This article has been updated from its original version, to link to a more recently revised version of the Medicare Benefit Policy Manual. Skilled nursing providers should ratchet up ...

As an attorney specializing in healthcare reimbursement, I have focused my practice on helping healthcare providers navigate the Center for Medicare and Medicaid (“CMS”) administrative appeal process.

Noncompliance at new deficiency tag F940, made effective in November 2019, will be cited if a facility fails to develop, implement, and maintain an effective training program for all staff. SOM ...

The 2024 Medicare Advantage Final Rule changed inpatient coverage, requiring healthcare providers to reevaluate their patient strategies. Unlike traditional Medicare Part A, Medicare Advantage (MA) ...

Angela Palo is COO of Pinnacle Financial Services, a leading National Medicare Brokerage, and member of the NABIP Medicare FMO Council. Medicare agencies and brokers juggle lead pipelines, sales ...

Participation in Medicare ordinarily requires physicians and practitioners to submit claims on behalf of beneficiaries and comply with statutory charge limits. However, Section 1802 of the Social ...