ChartMeds Advanced EMAR System

CMS needs to step up its involvement in states' Medicaid integrity programs according to a new federal watchdog report. http://www.gao.gov/assets/690/683376.pdf The agency is falling short in some areas of oversight relating to state's Medicaid audits, according to findings.... CMS lacks a system of collecting states' most promising Medicaid integrity practices and sharing them with other states. The report also noted CMS' collaborative audits has found substantial provider overpayments, barriers have limited their impact and the number of states that choose to use them GAO recommended to identify ways to address barriers that discourage states from participating in collaborative audits, and work with state officials to collect and share promising Medicaid integrity practices.

https://www.reddit.com//teaching_kids_the_joys_of_pc_gam/

"Languishing in a highly backlogged administrative process", court orders that HHS has 4 years to eliminate 700,000 Medicare appeals. HHS has until Dec. 31, 2020 to eliminate the backlog of pending Medicare reimbursement appeals, a federal court ordered on Monday. Judge James E. Boasberg, had stated in an earlier ruling that ordering the agency to resolve the backlog by the prescribed dates was extremely wishful thinking, but he changed course after briefs were filed by both parties.

A Florida nursing home operator charged as the ringleader of a record-setting $1 Billion (Yes, Billion!) Medicare fraud scheme will continue to be held without bond. Philip Esformes was arrested in July along with two others on allegations that he illegally shuffled residents in and out of his facilities, billed Medicare for unqualified residents and received kickbacks to refer beneficiaries to mental health and home healthcare providers.

HHS can't push off litigation over its overwhelming backlog of Medicare appeals, a federal court ruled on Monday. HHS had asked to stay the litigation until Sept. 30, which would allow the agency to perform administrative efforts designed to tackle the backlog of more than 700,000 appeals. The court ruling denied the motion, shooting down the proposed fixes as impressive-sounding action items that won't do much to curb the backlog as it grows to more than 1 million appeals.... Wrote Judge James E. Boasberg: ... the backlog and delays have only worsened since [HHS] first sought the Court's help, and the Secretary's proposed solutions are unlikely to turn the tide.

AHA: Federal proposal aimed at eliminating the backlog of Medicare appeals would just scratch the surface of the problem. This projection is striking because it signals to providers with claims already delayed in the appeals process that they may expect to wait five more years before these claims can be resolved, wrote Ashley Thompson, AHA senior vice president for public policy analysis and development.

http://www.mcknights.com//what-do-we-do-wh/article/517927/

https://getreferralmd.com//uploa/2013/09/doctor-humor2.jpg

Two elderly gentlemen were sitting on a bench under a tree when one turns to the other and says: "Slim, I'm 83 years old now and I'm just full of aches and pains. I know you're about my age. How do you feel?" Slim says, "I feel just like a newborn baby." ... "Really! Like a newborn baby?" "Yep. No hair, no teeth, and I think I just wet my pants"

One of our techs does pro bono work for a local retirement home and they are absolutely adorable trying to incorporate new technology. There was a question by a resident, and the complexity of the troubleshooting and problem-solving was actually kind of genius... This is what followed as they were trying to view a PDF: Resident: When I open it up in Word, the format is off.... Tech: That’s why you want to open it in Adobe Reader. Resident: We found it’s easier to open it directly into Word. Tech: And why is that? Resident: Because we have to use Word to make changes in the forms. It turns out that they would print out a form, white out the words that needed to be changed for some reason or another, scan it in as a picture, paste it into Word, type over the white out parts, then print it out again. He made them a form in Word so they could just edit it directly.

After a decade, the PACE program may get a major overhaul. The new proposal would allow for a more flexible approach to coordinating participants' care teams than the current structure, which only allows team members to fill one role on a care team. Nurse practitioners and others would also be allowed to provide some services instead of primary care physicians.

SNF owner arrested for stealing from residents to pay facility's debts. Wait... what? Yep, A California nursing home owner was arrested Thursday after an investigation revealed he had stolen thousands of dollars from more than 50 residents to cover the facility's debts. Michael Fellen, 65, allegedly used the money from resident's accounts to pay vendors, payroll and other costs at Sunnyside Convalescent Hospital in Fresno, CA, according to investigators. He was responsible ...for managing the trust funds for all residents at the nursing home. "He told investigators that he was in extreme debt, he needed to come up with some way of paying off his bills. So this was one way he was going about it," Fresno County Sheriff's Police Information Officer, Tony Botti said at a press conference. Jeez

Court: Arbitration agreement still enforceable even though SNF doesn't have copy of it A skilled nursing facility that doesn't have a copy of a signed arbitration agreement can still compel arbitration, the Indiana Court of Appeals ruled on Thursday. Golden Living inexplicably failed to retain a copy of the arbitration agreement, but the trial court concluded that sufficient extrinsic evidence existed to conclude that an enforceable agreement exists, Mathias wrote. We agre...e and conclude that the extrinsic evidence in the record resolves the ambiguity surrounding the parties to the arbitration agreement. Golden Living's former marketing director, Joni Lott testified that she gave the resident, Frank Cavazos, admissions and alternative dispute resolution agreements to sign and that she encouraged him to take them home and have someone else review them. Lott said that he appeared alert and coherent enough to understand the line of discussion, which included binding arbitration for any disputes. Cavazos died in 2013, two years after moving into the facility. Nine months after his death, personal representative Maureen Maynard filed suit, claiming negligence and breach of contract.