Vendors beware! Without an operating license or certificate from the State, entities in Missouri providing in-home personal care services face liability for up to five years, rather than the two-year statute of limitations, for claims against providers of health care services.
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One of the hardest hit industries during this COVID-19 pandemic is the nursing home industry. Nursing homes are doing the very best they can to prevent their residents and employees from getting this, in some instances, deadly corona virus.
Our firm would like to take time to say a heartfelt thank you to all of our health care clients and all other health care workers during this stressful time. You are working endless hours to protect and care for the vulnerable and sick. You are putting yourselves at risk while you spend time away from your families to care for others.
The Centers for Medicare and Medicaid Services (CMS) advised in June that it was going to back off its prior position on prohibiting nursing homes from including arbitration provisions in admission contracts. CMS has reversed its prior position and is currently drafting a new rule, which would allow pre-occurrence arbitration agreements to stand. The Fair Arbitration Now Coalition, the AARP, and other elderly advocacy groups are against CMS’ new position.
CMS issued an update regarding what appears to be a sharp increase in the denial rate for Skilled Nursing Facilities (SNFs) as reported in the 2015 Comprehensive Error Rate Testing (CERT) Report. The CERT Report showed denials increasing from 6.9% reported in 2014 to 11% in 2015. What did CMS attribute as the cause of this significant increase? DOCUMENTATION Here are some documentation requirements that CMS reported for the increase in denials resulting from missing or incomplete certification/recertification including: