INSURASALES

Tag: Healthcare Compliance

CMS Extends Medicare Revalidation Deadline for Skilled Nursing Facilities to 2026

CMS extends the Medicare off-cycle revalidation deadline for skilled nursing facilities to January 1, 2026, maintaining the existing requirements. Providers should prepare to comply to avoid Medicare participation disruptions.

US Files Civil Forfeiture Suits Over $33M Medicare Fraud by DME Providers

US government pursues civil forfeiture against two Florida DME companies accused of over $33 million in fraudulent Medicare claims for medically unnecessary equipment and services.

CMS Proposes Major 2026 Medicare Rule Changes Affecting Inpatient Care and Outpatient Surgery

CMS 2026 outpatient rule proposes major changes including inpatient-only list elimination and expanded ambulatory surgery center procedures, impacting Medicare payment and compliance.

Aetna Updates Medicare Advantage Inpatient Reimbursement Policy Effective Nov 15

Aetna implements a new inpatient reimbursement policy for Medicare Advantage plans to streamline payments and align with CMS two-midnight rule, effective Nov 15, 2023.

Virginia Foxx's Legislative Impact on Healthcare and Insurance Regulation

Analysis of Virginia Foxx's legislative positions affecting healthcare, insurance regulation, and employer health data management, with insights into compliance and market implications.

Key Medicare Part A Criteria for Skilled Nursing Facility Coverage Explained

Understand the Medicare Part A requirements for skilled nursing facility coverage, including qualifying hospital stays, coverage limits, and copay costs essential for healthcare professionals and insurers.

CMS Medicare Learning Network Web-Based Training Supports Provider Education

CMS offers a range of Medicare Learning Network web-based training courses for providers covering billing, coding, fraud prevention, and compliance. Courses are self-paced but do not provide continuing education credits. Subscribe to MLN Connects® for updates.

Villages Health System Files Chapter 11 Amid $350M Medicare Overbilling Probe

Villages Health System files Chapter 11 bankruptcy following a $350 million Medicare overbilling investigation amid increased Medicare Advantage audits and tighter regulatory scrutiny.

OIG Audit Reveals $100K+ Overpayments to HRS Home Health in Medicare Claims

OIG audit finds $100,696 in Medicare overpayments to HRS Home Health, highlighting compliance challenges in home health billing and the impact of CMS oversight.

Strategies to Combat Medicare Fraud and Reduce $60 Billion Annual Loss

Explore effective strategies to prevent Medicare fraud and reduce the estimated $60 billion in annual losses caused by fraud, errors, and abuse. Learn how beneficiaries and caregivers can safeguard against scams.