Blog: Healthcare Lawyers, Attorneys, Consultants, Firm

Payment Models in Post-Acute Healthcare Settings: A Primer

Payment Models in Post-Acute Healthcare Settings: A Primer

For several years now, CMS has been trying to move providers into value-based payment models. But they’ve recently recognized that pushing a hospital into a value-based model doesn’t mean that individual providers actually become value-motivated. Now, CMS is working to link a provider’s fee for service to the provider’s quality of care. MACRA and Payment...

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Does Your Practice Accept Medicare or Medicaid? You Need a Fraud, Waste, and Abuse Compliance Plan

Does Your Practice Accept Medicare or Medicaid? You Need a Fraud, Waste, and Abuse Compliance Plan

Illinois healthcare providers already face substantial challenges in delivering high-quality care to their patients. When you accept patients insured by Medicare or Medicaid, you also assume the additional legal obligation to ensure that you submit accurate reimbursement claims to the government. We are not simply talking about double-checking your bills for typos; you need a...

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How to Integrate the End of Medicare’s “Failure to Improve” Standard into Your Clinical Practices

How to Integrate the End of Medicare’s “Failure to Improve” Standard into Your Clinical Practices

If a Medicare patient has achieved their maximum level of recovery, and additional therapy would not help them improve beyond that point, then additional treatment isn’t warranted or medically necessary. Plus, Medicare surely won’t foot the bill.  You, their PT, think that additional therapy would help them from getting worse, but that’s not the standard. It’s time to discharge them,...

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How to Determine Whether Your Practice Should Accept Medicare: An Interview with an Active “Old Geezer”

How to Determine Whether Your Practice Should Accept Medicare: An Interview with an Active “Old Geezer”

My success in reaching 79 years of age might be attributed to moderation in the usual "abuses"--alcohol, drugs, tobacco, stress, excessive food and lots of exercise every day.  Had I subscribed to this regimen when I was in my 30's and 40's, it would have been even more prudent -- maybe leading me to tip over the century mark.  But who really wants to do...

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