Hospital Employees Fired for Celebrity Snooping

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You’ve heard the saying “curiosity killed the cat,†well in the case of dozens of hospital employees, curiosity may have killed their careers. Earlier this month, Chicago’s Northwestern Memorial Hospital fired dozens of employees who allegedly accessed the medical records of actor Jussie Smollett without authorization, according to numerous published reports. The Empire actor was…

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OIG: Complimentary In-Home Care Permitted, Despite Potential Anti-Kickback Violation

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A recent advisory opinion issued by the U.S. Department of Health and Human Services Office of the Inspector General has given a medical center the go-ahead to provide free in-home care to reduce re-admissions, despite a prohibition against giving patients handouts that might influence care decisions. The OIG advisory opinion is in response to a…

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Judge Rules United Behavioral Health Guidelines Led to Denial of Claims Violations

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A California federal judge has issued a landmark ruling that could impact the way insurance companies cover mental health and substance use treatment. Chief Magistrate Judge Joseph Spero of the District Court for the Northern District of California ruled that United Behavioral Health (UBH) used “flawed†internal guidelines resulting in the unlawful denial of mental…

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CMS to Phase Out Split-Percentage Payments for New HHAs

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Despite concerns from home health agencies (HHAs) that their cash flow could be significantly impacted, the Centers for Medicare & Medicaid (CMS) has announced that beginning in calendar year 2020 HHAs that are certified for participation in Medicare on or after January 1, 2019, will no longer receive split-percentage payments. Split-percentage payments allow a home…

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