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Top Ten Health Care Issues to Follow in the Carolinas in 2021

2020 was an historical year in the health care industry with the global COVID-19 pandemic being the most impactful issue for most of the year. As we enter 2021, we are tracking the following issues which will have an impact...more

Update on Hospital Price Transparency Rules Effective January 1, 2021

In November 2019, the Centers for Medicare and Medicaid Services (CMS) published the Final Rule implementing Section 2718(e) of the Public Health Service Act, aimed at making hospital pricing for common services more...more

Transparency in Pricing Trend Continues with New Federal Rule that Applies to Health Plans

On October 29, 2020, the Department of Health and Human Services (HHS), the Department of Treasury, and the Department of Labor issued a new “transparency in coverage” final rule that is focused on insurance companies and...more

Serving on the Board of Directors of a Health Care Provider Organization During COVID-19

Serving on a Board of Directors of a health care provider organization like a hospital, a physician practice, an ambulatory surgery center, a community health center, or some other type of provider is an important job that...more

A Glimpse at Recent State and Federal COVID-19 Testing Developments

At both the state and federal level, COVID-19 testing is the focus of regulatory focus. On May 6, 2020, the South Carolina Department of Health and Environmental Control announced that it will conduct statewide COVID-19...more

Emergency Health Powers Act (S.C. Code Ann. §§ 44-4-100–44-4-570) (Regulatory Implementation: S.C. Code Ann. Regs. 61-112)

On March 13, 2020, in accordance with Sections 1-3-420 and 25-1-440 of the South Carolina Code of Laws, as amended, Governor Henry McMaster declared a state of emergency due to the public health emergency caused by the 2019...more

NCI Awarded Payment Error Rate Measurement Review Contractor (PERM RC) by HHS

If you are a Medicaid and CHIP provider, please be aware of the latest post-payment claims reviewer we have detailed here. We anticipate providers will be faced with additional stress and burden when this new PERM RC...more

Three Strikes and You're Out: CMS Targeted Probe and Educate (TPE) Process

Has your practice received a Targeted Probe and Educate (TPE) audit from a Medicare Administrative Contractor (MAC)? If so, did you know you only have three strikes before you’re out?...more

Creativity Over Hammers - Solving the Veterans Affairs Choice Problem Without a Recovery Audit Contractor

Over the last several years, the US Department of Veterans Affairs (VA) has experienced numerous high profile problems with its operations and the delivery of to our veterans. The recent discovery of the depletion of the...more

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