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Homeostasis: Health Care Law Blog

Posts by Richard Y. Cheng


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Showing 2 posts by Richard Y. Cheng.

Medicare Coverage for Ambulance Services – Physician Certification Will Not Be Enough

A physician certification for Medicare coverage for ambulance services is not the final word. An ambulance service also must demonstrate the beneficiary’s condition and establish medical necessity when transporting the Medicare beneficiary. In a recent Southern District of Texas decision, the Court affirmed a decision by the Department of Health and Human Services (“HHS”) to deny payment to an ambulance service that provided repeated non-emergency transport to a Medicare beneficiary when the service failed to show that transportation by another means was contraindicated by the patient’s condition. Read More ›

Federal Standards and State Agency Oversight in Assisted Living Facilities

Earlier last month, a Government Accountability Office (GAO) report provides results of a nationwide survey of Medicaid state agencies containing data specifically focused on assisted living services. The report showed only 22 of 48 participating states were able to provide meaningful information on the number of "critical incidents" in assisted living facilities (ALFs). Critical incidents include physical abuse, neglect, or exploitation. Additionally, the report showed that more than $10 billion dollars in federal and state Medicaid funding is spent annually on providing Americans access to assisted living. Read More ›