August 1, 2015 Legislation




CMS has again fined the Medicare Advantage plan New West Health Services.  This time it is $204,200.  They failed to correct prior violations.  In January the organization was fined $349,800 for not paying claims on a timely basis for out of network providers.  The next level is termination from Medicare.

Colorado has started the process to join after the Supreme Court ruling allowing subsidies at the federal level.  They would join Oregon, New Mexico, Hawaii and Nevada.  The Colorado exchange to date has been a disaster like the other failed exchanges.

HealthNet has been fined $350,000 by the feds for giving erroneous information to 14,000 Medicare customers.        Top


The second hospital in two weeks has been defunded by CMS.  This time it is Winnebago Indian Health Service Hospital in Nebraska.  The hospital has not filed an appeal according to the news but has according to the hospital spokesman.  The CMS found that the hospital had caused immediate jeopardy to patients.

The original hospital that lost its funding, Cochise, in Arizona has announced it will close.

Parkview Hospital in Brunswick Maine, should no longer receive Medicare or Medicaid funds according to the CMS.  They filed for bankruptcy on June 16, and closed its inpatient facility June 18.  It therefore is no longer a hospital.  They had transferred all of the inpatient care to a neighboring hospital.

NOTICE has sailed through both houses of Congress and the President is expected to sign it.  The new law requires hospitals to notify Medicare beneficiaries of observation status and their financial obligations within 36 hours of their discharge.  This is important for those who go on to SNFs and would be asked to pay the bill.        Top


DISCLAIMER: Although this article is updated periodically, it reflects the author's point of view at the time of publication. Nothing in this article constitutes legal advice. Readers should consult with their own legal counsel before acting on any of the information presented.