Medicare Fraud: $2.75 Billion Recovered

Late June, the Department of Justice released its 2024 Healthcare Fraud Enforcement Action, detailing actions against nearly two hundred individuals, encompassing Medicare fraud totaling $2.75 billion in recovered losses ($1.6 billion in actual cash losses). One of the major problems with Medicare, aside from its structural financing, is that it is bureaucratically bloated, full of … Read more

DOJ Gets Aggressive in Pursuit of Telehealth Fraud

It was only a matter of time before cases involving telehealth fraud/False Claims Act cases became public.  This week, two press releases from the DOJ illustrated how aggressive the agency has become in the pursuit of telehealth related fraud. I suspect more, larger in implication (dollar value, geographic spread), will drop publicly in the next … Read more

Sr. Living Capital Access Still Challenged

Last week, a report from NIC (National Investment Conference) dropped covering the fourth quarter (2023) lending activity in senior living. As in prior quarters, capital access remains challenged. Data for the report came from 17 lenders, including banks, commercial real estate services, financial services companies, government sources, investment management firms, and real estate investment trusts. … Read more

FTC Bans Employment Non-Compete Provisions – Healthcare Implications Aplenty

On Tuesday, the Federal Trade Commission issued a final rule effectively, banning non-compete agreements, provisions, etc. for employees, including executives. The final rule contains separate provisions defining unfair methods of competition for the two subcategories of workers. Specifically, the final rule provides that, with respect to a worker other than a senior executive, it is … Read more

Wednesday Feature: Massachusetts Nursing Home Residents Set to Transition to Community Living with $1 Billion Settlement

Happy Hump Day! Last week, the Lieutenant Governor of Massachusetts, Kim Driscoll, announced the settlement of a class action lawsuit filed against the state by six disabled nursing home residents. The suit was filed in 2022 alleging that the state underfunded community-based care options, trapping them in nursing homes despite their wishes to return to … Read more

Challenges Persist in Staffing for U.S. Life Plan Communities and Skilled Nursing Facilities

Monday, Fitch Ratings dropped a Non-Rating Commentary about staffing challenges in Life Plan and SNF organizations. Per the release, “Though growing for some time, payrolls for U.S. life plan communities (LPCs) and skilled nursing facilities (SNFs) are still well off the pace needed to reach a full post-pandemic recovery.” Bureau of Labor Statistics (BLS) data … Read more

Wednesday Feature: Budget Stuff…Cubed

Happy Hump Day! Busy day so far but wanted to sneak this post in, wrapping up the last two days of posts on budget (federal, Medicare) stuff. This being the third day and post on budgets (and last for a while, I promise), the title fits – cubed. https://rhislop3.com/2024/04/15/monday-budget-day/ https://rhislop3.com/2024/04/16/medpac-report-to-congress-a-wrap-with-monday/ What follows is a different … Read more

MedPAC Report to Congress: A Wrap with Monday?

Yesterday I wrote a post on President Biden’s healthcare budget. Today, I thought a quick visit back to March and MedPAC’s Annual Report to Congress on payment and program adequacy would be a good “wrapper” – for now. Every year, MedPAC (the Medicare Payment Advisory Commission) reports to the Congress in March on the Medicare … Read more

Monday = Budget Day

As much as politics consumes the news, little on policy is included. Most days, the political stuff such as trials, Congressional hearings, back and forth tabloid (almost) stuff is front and center, missing is the “meat”. Reminds me of the 80’s Wendy’s commercial titled, “Where’s the beef?” https://www.youtube.com/watch?v=riH5EsGcmTw While I know that the national election, … Read more

The Dark Side of the Economy

On Monday, a good portion of the U.S. saw all or portions of a total eclipse. If you were in the “zone of totality”, you saw a heck of a show and witnessed the side-effects of day turning to dark and the weather turning noticeably colder. Cool stuff. Unfortunately, within the past week or so, … Read more