Medicare Advantage plan denials for prior authorization set record at 3.4 million
By
Kathleen Steele Gaivin
Aug 12, 2024
Medicare Advantage plans denied a record number of requests for prior authorization in 2022, according to a KFF analysis of federal data published Thursday.
Joint venture brings new I-SNP to PA nursing home residents
By
Kathleen Steele Gaivin
Aug 08, 2024
A new joint venture has created American Health Advantage of Pennsylvania, an institutional special needs plan, or I-SNP, to serve Medicare and Medicaid beneficiaries who live in nursing homes in 12 counties...
Business briefs, July 31
By
Kathleen Steele Gaivin
Jul 31, 2024
PA law limits use of noncompetes for healthcare practitioners, effective Jan. 1 … ClearWellness, University of North Texas collaborate on study of wellness benefits in independent living communities...
Long-term care providers among 193 criminally charged, $2.75 billion in fraud recoveries so far in 2024
By
Kathleen Steele Gaivin
Jul 01, 2024
The Justice Department has recovered more than $2.75 billion in false claims against healthcare providers and charged 193 defendants so far this year in criminal cases through its 2024 National Health...
Record-high False Claims Act settlements recovered in first half of 2024
By
Kathleen Steele Gaivin
Jun 21, 2024
After a record-breaking 2023, settlements under the False Claims Act continue along the same trajectory in the first half of 2024, “with notable healthcare fraud settlements under the FCA, AKS [the Anti-Kickback...
Nursing homes struggle with tighter reimbursement environment, expert says
By
Kathleen Steele Gaivin
Mar 20, 2024
Nursing home funding challenges, capital and private equity firms were among the subjects of a webinar Tuesday sponsored by the Long Term Care Community Coalition.
Business briefs, March 13
By
Kathleen Steele Gaivin
Mar 13, 2024
Fillmore Capital Partners gets nursing home fraud suit dismissed … Fortune questions nursing home ownership, quality ties … HHS FY25 budget has $150B for Medicaid HCBS, cybersecurity … CMS delivers...
Business briefs, March 7
By
Kathleen Steele Gaivin
Mar 07, 2024
Medicare opportunities in senior living and skilled nursing … Bill would provide funding to states to help dual eligible seniors navigate Medicare and Medicaid … 1,000+ workers strike at 12 Minnesota...
New group will advocate for dually eligible nursing home residents, other beneficiaries
By
Kathleen Steele Gaivin
Feb 22, 2024
A newly formed alliance of healthcare and consumer organizations has formed to advance the integration of Medicare and Medicaid for dually eligible nursing home residents and other older adults.
With projected Fed decreases, investor confidence is rising
By
Kathleen Steele Gaivin
Feb 21, 2024
The past few years have been challenging on debt markets in real estate, particularly in the senior living and care market, but a “boost in investor confidence” is occurring now, according to Jason...