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Tag: LTC

Fraud & Abuse: OIG Targets LUPA Gaming In Newest Work Plan Item

  • By Sandy McCleve
  • July 3, 2018
  • No Comments

Feds will examine cases where one visit translates to additional thousands of dollars. Just where do you fall in relation to your peers when it comes to episodes barely exceeding … Continue Reading →

Compliance: Take These 4 Steps To Head Off LUPA Troubles

  • By Sandy McCleve
  • July 2, 2018
  • No Comments

Your PEPPER report could come in handy. With attention on low-visit episodes heating up, now’s the time to make sure your related claims can stand up to reviewer examination. In … Continue Reading →

Hospice: Fraud Settlement Leads To Execs’ Salaries Splashed Across The Newspaper

  • By Sandy McCleve
  • June 28, 2018
  • No Comments

Hospice nursing supervisor admits to hastening patients’ death with overmedication. Two hospice fraud and abuse cases have widely publicized developments that may make hospices’ missions harder. Case #1: Trustbridge, the … Continue Reading →

Enforcement: OIG Racks Up Big Numbers In Latest Period

  • By Sandy McCleve
  • June 27, 2018
  • No Comments

Nearly $1.5 billion in recoveries keeps the OIG on task. If you’re waiting for federal fraud-fighting efforts to lighten up, you’ll be waiting a long time. So indicates the latest HHS … Continue Reading →

Medical Review: Illinois HHAs Hope For Generous Exemptions To RCD

  • By Sandy McCleve
  • June 26, 2018
  • No Comments

Even agencies that qualify for exemption will be subject to 5% ‘spot check.’ One of the most pressing questions for the home health agencies scheduled to undergo the relaunched Pre-Claim … Continue Reading →

Fraud & Abuse: OIG Shines Spotlight On Home Care Fraud

  • By Sandy McCleve
  • June 25, 2018
  • No Comments

Watchdog agency profiles Texas, Florida cases. The feds continue to paint home care with a broad fraud brush, as evidenced by the OIG’s latest Semiannual Report to Congress. “Home- and community-based … Continue Reading →

Utilization: Hospice Payment Reform Fails To Move The Needle On Skilled Visits At End Of Life

  • By Sandy McCleve
  • June 22, 2018
  • No Comments

Only slight improvement shown by claims data. Medicare’s hoped-for solution for boosting care levels in the last days of life has yet to materialize, the 2019 proposed rule for hospice … Continue Reading →

Hospice: Prior Auth For Common Drugs May Be On Hospice Horizon

  • By Sandy McCleve
  • June 21, 2018
  • No Comments

You should be paying for insulin, beta blockers, and more, CMS instructs. Data revealed in the latest hospice payment proposed rule may indicate more medication payment crackdowns for hospices — … Continue Reading →

Know Your Facts: Live Discharge Rate Dropped Again In 2017

  • By Sandy McCleve
  • June 20, 2018
  • No Comments

LOS ticks upward. You have only a matter of days left to give Medicare your two cents on its proposed rule for hospice payment for next year. Consider these 2017 … Continue Reading →

Medical Review: Industry Mobilizes For Pre-Claim Review Opposition

  • By Sandy McCleve
  • June 19, 2018
  • No Comments

Learn from original PCR run, trade group tells Medicare officials. Unlike with the original Pre-Claim Review demonstration, home health agencies are hoping to head off the medical review project before … Continue Reading →

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About Me

Sandy McCleve is the Managing Director at Advantage Healthcare Consulting with nearly a decade of experience as an accounting and tax preparation consultant specifically for healthcare providers.

Sandy has developed proprietary tools and systems that allow Advantage Healthcare Consulting to provide the fastest, most accurate cost reports and truly qualifies him as a specialist in Medicare and Medicaid Cost Reporting for Home Health Care Agencies, Hospice Care Providers, and Skilled Nursing Facilities.

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