Ashley Morgan

Medicare Advantage SIU Audits and Investigations are More Prevalent Than Ever

Medicare, Medicaid & Private Payor Updates, Other / By

Author: Ashley Morgan, Annabella Denzel (April 5, 2023): In the sphere of healthcare compliance, providers must manage audits coming from every possible authority whether it be from public agencies, a private payor, or other third-party authorities. CMS has announced that the FY 2022 fee-for-service improper payment rate was 7.46%.[1] While this is a slight increase …

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Inflation Reduction Act: What is the Impact on Healthcare Providers?

Medicare, Medicaid & Private Payor Updates / By

Author: Ashley Morgan, Annabella Denzel (March 30, 2023): On August 16, 2022,[1] President Biden signed the Inflation Reduction Act (IRA) into law, bringing with it plans for broad sweeping changes to tax rates, energy prices, and—most importantly for our purposes — healthcare costs. The general consensus from providers is that because the IRA’s healthcare related …

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Amniotic Fluid / Amniotic Membrane Tissue Audits, Investigations and Prosecutions are Continuing to Climb in 2022

Medicare, Medicaid & Private Payor Updates / By

(August 4, 2022): Over the past year, we have seen a significant increase in the number of Medicare administrative audits, False Claims Act investigations and criminal prosecutions by the Department of Justice (DOJ), related to the billing of allogeneic (harvested from someone else) stem cell products. Medicare and Medicaid claims stemming from amniotic liquid and …

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The Coronavirus Aid, Relief and Economic Security (CARES) Act: Provisions Relevant to Healthcare Providers

COVID-19 Updates, Medicare, Medicaid & Private Payor Updates / By

By Michael Cook, Jennifer Papapanagiotou & Andy Lynch –  Partners at Liles Parker, PLLC. (March 31, 2020):  On March 27, 2020, the Coronavirus Aid, Relief and Economic Security (CARES) Act[1] passed the House of Representatives by a voice vote. The President then signed the bill into law. The bill is the third round of federal …

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Small Business Administration Releases Express Bridge Loan Pilot Program for COVID-19

COVID-19 Updates, Medicare, Medicaid & Private Payor Updates / By

(March 26, 2020): The Small Business Administration (“SBA”) announced an Express Bridge Loan Pilot Program on March 25, 2020.[1] The Express Bridge Loans are available to businesses, including health care providers, to provide economic relief for businesses impacted by the Coronavirus Disease (COVID-19) while they await long-term disaster financing.[2] I. Background: The Express Bridge Loan …

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Lab Testing Guidance for COVID-19

COVID-19 Updates, Medicare, Medicaid & Private Payor Updates / By

(Updated March 31, 2020): On March 13, 2020, President Trump declared a National Emergency[1] related to the current Coronavirus / COVID-19 outbreak. The declaration gives Secretary Alex Azar of the U.S. Department of Health & Human Services (HHS) the power to waive certain Federal requirements in Medicare, Medicaid and CHIP in order to address the …

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COVID-19 Outbreak Update – Two Recent Updates From CMS Affecting Relief From Quality Reporting Requirements, And New Targeted Plan For Healthcare Facility Inspections Including Provider-Self Assessment Tool For Infection Control

COVID-19 Updates, Medicare, Medicaid & Private Payor Updates / By

(March 25, 2020): As our clients and all members of the health care community are acutely aware, the challenges raised by the Coronavirus / COVID-19 outbreak are critical and widespread. Because of these challenges, the Centers for Medicare and Medicaid Services (CMS) and other principal operating components of the United States Department of Health and …

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COVID-19 SBA Loan Support May be Available for Qualified Health Care Providers

COVID-19 Updates, Medicare, Medicaid & Private Payor Updates / By

(March 25, 2020): The Small Business Administration (SBA) offers loans to small businesses through community lenders. The SBA acts as guarantor for these loans. In addition to the traditional lending, the SBA is also authorized to offer disaster assistance to businesses, renters, and homeowners who are located in regions with “declared disasters.”[1] Small businesses impacted …

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Recent Developments in Personal Care & Community-Based Services in Medicaid and Medicare

Home Health & Hospice / By

(March 23, 2020): Until recently, personal care services, such as home health aides, were not covered under the Medicare program unless they were part of a skilled service where the beneficiary was homebound.  However, beginning with calendar year 2019, the Medicare program has expanded the ability of plans that participate in the Medicare Advantage program …

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