Tag archive: skilled nursing facilities

CMS Update – Sharp Rise in Denials for SNF Claims

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…

Fraud & Abuse Alert: OIG targets Excluded Employees

The OIG has demonstrated an increased focus on investigating employers to determine whether any employees are excluded from participating in Federal health care programs. When the OIG investigations reveal excluded employees, who allegedly provided items and services to Federal health care programs beneficiaries resulting in payments to the employers, the OIG has sought and obtained…

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