Alice Harris on Medicaid

Nursing Home Operators Wary of Steep Medicaid Cuts as "One Big Beautiful Bill" Moves to Senate

Even as long-term care providers celebrate a proposed 10-year moratorium on the nursing home staffing mandate[1], they are sounding the alarm over major Medicaid cuts included in the House-passed budget reconciliation bill...more

6/17/2025 / Centers for Medicare & Medicaid Services (CMS) , Federal Budget , Health Care Providers , Healthcare Facilities , Healthcare Reform , Long Term Care Facilities , Medicaid , Nursing Homes , Proposed Legislation , State Budgets

Resources and Practical Response Tips

After a lengthy absence, the South Carolina Department of Health and Human Services (“SCDHHS”) announced on September 10, 2024, that its Medicaid Recovery Audit Contractor (“RAC”) program was resuming on October 1, 2024. ...more

9/18/2024 / Audits , Health Care Providers , Medicaid , Physicians

Federal Long Term Care Staffing Mandates: Impacts on Facilities Across the Country and in Alabama

On May 10, 2024, the Centers for Medicare & Medicaid Services (CMS) published its controversial final rule imposing minimum staffing requirements for long term care facilities (the “Final Rule”). When it takes effect on June...more

5/21/2024 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Long Term Care Facilities , Long-Term Care , Medicaid , Medicare , Nursing Homes

Billing Medicare or Medicaid? Understanding Your Audit Risk

If you are a healthcare provider enrolled with Medicare and Medicaid, it is imperative that you know the governmental agencies’ expectations for compliant billing and understand that the agencies constantly monitor and audit...more

7/12/2023 / Centers for Medicare & Medicaid Services (CMS) , Medicaid , Medicare , Medicare Administrative Contractors (MAC) , OIG , Recovery Audit Contractors (RACs) , Skilled Nursing Facility , SMRC

The End of PHE Flexibilities – How to Navigate Upcoming Changes in Healthcare

On January 30, 2022, President Biden announced that the Covid-19 Public Health Emergency (PHE) will finally end on May 11, 2023.[1] Since the PHE was declared on January 31, 2020, emergency declarations and waivers were...more

2/17/2023 / Centers for Medicare & Medicaid Services (CMS) , Children's Health Insurance Program (CHIP) , Coronavirus/COVID-19 , Infectious Diseases , Medicaid , Medicare , Public Health Emergency , Skilled Nursing Facility , Telehealth

South Carolina Medicaid to Restart Member Eligibility Reviews – Details and Action Steps for Providers and Their Medicaid...

At the end of January 2022, President Biden announced that the Covid-19 Public Health Emergency (PHE) will end on May 11, 2023. At that time, the Medicaid Program “continuous enrollment provision” will end and State Medicaid...more

2/17/2023 / Coronavirus/COVID-19 , Health Care Providers , Medicaid , Public Health Emergency

OIG to Audit Nursing Home Services Rendered Prior to Inpatient Hospitalizations – Four Steps to Take to Prepare for the Increase...

Efforts to reduce avoidable inpatient hospitalizations among nursing facility residents have been ongoing for years. As an example of these initiatives, CMS ran a program from 2012 to 2020 focusing on long-stay long-term...more

10/25/2022 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicaid , Medicare , Nursing Homes , OIG

Increased Enforcement Means Need to Review Credit Balance Procedures

On December 10, 2021 a hospital in Illinois made the news when it was reported that Gibson Area Hospital had agreed to pay $292,000 to settle False Claims Act (“FCA”) allegations of failing to return overpayments received...more

1/6/2022 / Centers for Medicare & Medicaid Services (CMS) , False Claims Act (FCA) , Health Care Providers , Hospitals , Medicaid

Health Care Reimbursement: Experience Matters. The Who, What, When, Where, and Why of Healthcare Reimbursement Coverage,...

The laws and policies surrounding the financial relationship between payors and healthcare providers is healthcare reimbursement law. Our attorneys and consultants have broad experience handling matters involving the full...more

9/22/2020 / Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicaid , Medicare , Reimbursements , TRICARE

Alice Harris

Maynard Nexsen

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