Lanchi Nguyen Bombalier on Administrative Law Judge (ALJ)

Takeaways From AHLA’s Institute on Medicare and Medicaid Payment Issues

AGG Healthcare attorneys Lanchi Bombalier and Charmaine Mech recently attended the American Health Law Association (AHLA)’s Institute on Medicare and Medicaid Payment Issues in Baltimore, Maryland, from March 23-25, 2022. The...more

4/6/2022 / Administrative Law Judge (ALJ) , Enforcement Priorities , Health Insurance , Healthcare , Healthcare Facilities , Healthcare Fraud , Medicaid , Medicare , Provider Payments , Regulatory Agenda

Good News for Medicare Providers as CMS Expands Settlement Conference Facilitation and Introduces New Initiative for IRFs

The Centers for Medicare and Medicaid Services (CMS) made a number of recent changes to expand the Settlement Conference Facilitation (SCF) process for providers and suppliers mired in the backlog of appeals at the...more

8/6/2019 / Administrative Law Judge (ALJ) , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Inpatient Rehab Facilities , Medicare

Office of Medicare Hearings and Appeals To Hold Open Door Call on Upcoming Expansion of Settlement Conference Facilitation Program

In preparation for the upcoming expansion of its Settlement Conference Facilitation (SCF) program, the Office of Medicare Hearings and Appeals (OMHA) has directed interested providers and suppliers to review the SCF Expansion...more

5/16/2018 / Administrative Law Judge (ALJ) , Centers for Medicare & Medicaid Services (CMS) , Medicare , Medicare Appeals Council , OMHA

CMS Announces Low Volume Appeal Settlement Option for Providers Mired in ALJ Backlog

On January 9, 2018, the Centers for Medicare and Medicaid Services (CMS) announced details on the new low volume appeal settlement option, which is the latest alternative available to Medicare Part A and Part B providers and...more

1/25/2018 / Administrative Law Judge (ALJ) , Appeals , Centers for Medicare & Medicaid Services (CMS) , Medicare Part A , Medicare Part B , OMHA

CMS Issues Update for Contractors Defending Medical Review Decisions at Medicare ALJ Hearings

On October 13, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a CMS Transmittal to update the Medicare Program Integrity Manual (MPIM) on recent regulatory changes in the Office of Medicare Hearings and...more

12/20/2017 / Administrative Law Judge (ALJ) , Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Medicare

D.C. Circuit Finds District Court Abused Discretion by Implementing a 4 Year Deadline to Clear Backlogged Administrative Appeals

On August 11, 2017, the D.C. Circuit issued its decision on the District Court’s order in American Hospital Association v. Price in a 2-1 decision, holding that the District Court abused its discretion by ordering the...more

9/7/2017 / Administrative Appeals , Administrative Law Judge (ALJ) , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS)

HHS Announces Final Rule to Remedy Medicare Appeals Backlog

On January 17, 2017, the Department of Health and Human Services (HHS) released a Final Rule announcing a three-prong appellate process change in an effort to decrease the growing Medicare appeals backlog at the...more

1/31/2017 / Administrative Law Judge (ALJ) , Department of Health and Human Services (HHS) , Final Rules , Medicare , Medicare Appeals Council , OMHA

CMS Limits the Scope of Review for Certain Redeterminations and Reconsiderations

For providers who have received inconsistent or varying reasons for denial while navigating through the Medicare appeals process, the Centers for Medicare & Medicaid Services (CMS) has provided much-needed relief in the form...more

9/3/2015 / Administrative Law Judge (ALJ) , Appeals , Centers for Medicare & Medicaid Services (CMS) , MACs , Medicaid , Medicare , Motion for Reconsideration , QICs , Scope of Review

Lanchi Nguyen Bombalier

Arnall Golden Gregory LLP

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