ALJ

Combative residents, non-paying residents, disruptive residents, residents needing a higher level of care. We have seen them all the time, but it appears after COVID-19 that more and more facilities are...

Let’s try a little thought experiment. Imagine you are the owner or operator of a skilled nursing facility. Or, you are the director of nursing, administrator, therapist, nurse aide or physician. ...

Ten years – that’s how long the U.S. Department of Health and Human Services Office of Medicare Hearings and Appeals estimates the Medicare appeals backlog of 750,000 cases will take to clear.

Long-term care providers have been outspoken in their criticism of the Medicare appeals process, which has all but ground to a halt. Now a class-action lawsuit says Medicare beneficiaries also are being...

Efforts to root out Medicare fraud have put far too many above-board providers in auditors’ crosshairs, leading to a staggering backlog of appeals that has no easy fix, Congressional lawmakers and...

Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced...