Medicare insurers have widely varying rejection rates for patients seeking nursing-home stays. This is also true for long-term care hospitals and inpatient rehabilitation facilities, according to two new reports from the Office of Inspector General for the Department of Health and Human Services. Among the most likely to initially refuse access to the costly facilities are Medicare insurers with
The American Prospect had an interesting article about the incredibly profitable insurance industry. If not for the power of insurance float, the empire of Warren Buffett’s Berkshire Hathaway would not exist. Insurance float is the profit earned in the period of time between collecting premiums and before payouts to clients. The longer they delay paying
Medicare changed the rules for paying skilled nursing facilities in hopes of reducing waste, fraud, and abuse. Instead of rewarding therapy volume, the new payment model placed more weight on patient diagnoses and clinical complexity. That was the intent. A recent Forbes piece highlights what happened next: facilities began coding residents as having more illnesses
For any attorney who makes a living lying through their cases or embezzling money—you’re in luck. Slate reported that Attorney General Pam Bondi was working to make your life much easier. As of last week, Bondi has been quietly working with the DOJ to revoke state bars’ rights to investigate fraudulent lawyers. This means that
South Carolina’s Community Choices Medicaid waiver is designed to help elderly residents who qualify for nursing home level care remain in their homes or communities rather than entering a facility. Participants must meet the same clinical criteria required for institutional placement, meaning they often need assistance with basic activities of daily living such as bathing,
The ongoing bankruptcy of Genesis HealthCare shows just how easily corporate nursing home chains can dodge accountability, even after families win hard-fought settlements for injuries and deaths. CBS News and KFF Health News reporting makes it clear: Genesis settled at least 155 lawsuits involving serious harm and wrongful death, often with delayed-payment provisions, and still