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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

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

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

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

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

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