42 C.F.R. §424.22 - Requirements for home health services
| Cite as | 42 C.F.R. §424.22 |
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69 practice notes
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United States ex rel. Prather v. Brookdale Senior Living Cmtys., Inc., No. 17-5826
...provided. These certifications need to "be obtained at the time the plan of care is established or as soon thereafter as possible." 42 C.F.R. § 424.22(a)(2). But the defendants were allegedly obtaining certifications months after patients' plans of care were established.In July 2012, Prathe......
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Sahara Health Care, Inc. v. Azar, CIVIL ACTION NO. 7:18-CV-203
...Dkt. No. 1 pp. 18–19, ¶¶ 74, 76, 79.95 Dkt. No. 20 p. 3.96 See 42 U.S.C. § 1395kk-1 ; 42 C.F.R. §§ 405.904(a)(2), 405.920 –405.928.97 42 C.F.R. § 424.22.98 Family Rehab. , 886 F.3d at 499–500 (emphasis added).99 Maxmed Healthcare, Inc. v. Price , 860 F.3d 335, 338 (5th Cir. 2017) (citing 42......
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Family Rehab., Inc. v. Azar, No. 17-11337
...Rehab is required to perform an initial home health certification for each patient in conformity with various regulatory requirements. 42 C.F.R. § 424.22.The Centers for Medicare and Medicaid Services ("CMS") is a division of the U.S. Department of Health and Human Services ("HHS") and is r......
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United States ex rel. Prather v. Brookdale Senior Living Cmtys., Inc., No. 15–6377
...home health services only if a physician certifies and recertifies” the patient's eligibility for and entitlement to those services. 42 C.F.R. § 424.22. The physician must certify that: (1) home-health services “are or were required because the individual is or was confined to his home ... ......
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35 cases
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United States ex rel. Prather v. Brookdale Senior Living Cmtys., Inc., 17-5826
...provided. These certifications need to "be obtained at the time the plan of care is established or as soon thereafter as possible." 42 C.F.R. § 424.22(a)(2). But the defendants were allegedly obtaining certifications months after patients' plans of care were established.In July 2012, Prathe......
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Harris v. Quinn, 11–681.
...Abood 's reach. Medicare-funded home health employees may be one such group. See Brief for Petitioners 51; 42 U.S.C. § 1395x(m) ; 42 CFR § 424.22(a). The same goes for adult foster care providers in Oregon ( Ore.Rev.Stat. § 443.733 (2013)) and Washington ( Wash. Rev.Code § 41.56.029 (2012))......
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Family Rehab., Inc. v. Azar, 17-11337
...Rehab is required to perform an initial home health certification for each patient in conformity with various regulatory requirements. 42 C.F.R. § 424.22.The Centers for Medicare and Medicaid Services ("CMS") is a division of the U.S. Department of Health and Human Services ("HHS") and is r......
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United States ex rel. Prather v. Brookdale Senior Living Cmtys., Inc., 15–6377
...home health services only if a physician certifies and recertifies” the patient's eligibility for and entitlement to those services. 42 C.F.R. § 424.22. The physician must certify that: (1) home-health services “are or were required because the individual is or was confined to his home ... ......
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26 firm's commentaries
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False Claims Act: 2018 Year-in-Review
...Circuit concluded that the relator sufficiently alleged materiality by alleging that defendants violated the timing provision of 42 C.F.R. § 424.22(a)(2). This provision, the Court held, was an express condition of payment that goes to “the very essence of the [government’s] bargain.” Id. a......
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Untimely Physician Certifications For Medicare Home Care ClaimsArguably A TechnicalityVulnerable To False Claims Act Allegations: Sixth Circuit
...home health services only if a physician certifies and recertifies the patient's eligibility for an entitlement to those services. 42 C.F.R. § 424.22. These certifications are essentially projections about the patient's medical need and plan of care. Medicare currently pays home health ag......
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Untimely Physician Certifications for Medicare Home Care Claims—Arguably a Technicality—Vulnerable to False Claims Act Allegations: Sixth Circuit
...home health services only “if a physician certifies and recertifies” the patient’s eligibility for an entitlement to those services. 42 C.F.R. § 424.22. These certifications are essentially projections about the patient’s medical need and plan of care. Medicare currently pays home health ag......
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Sixth Circuit: Timing of Physician Certification for In-Home Care Remains Material After Escobar
...of care is established or as soon thereafter as possible and must be signed and dated by the physician who establishes the plan.” 42 C.F.R. § 424.22(a)(2). The nurse accused the providers of failing to comply with this timing requirement and instead submitting claims without a certification......
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