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Marcum LLP



Marcum LLP's experience within the Healthcare industry covers the full continuum of care with a special focus within the post-acute care geriatric segments of the industry, hospitals, and physician practices.

We go beyond providing traditional audit and tax services to the industry and truly understand the clinical, regulatory, reimbursement and operational challenges facing today's healthcare industry.

To best serve our clients we have assembled a team of professionals dedicated to meeting the needs and providing resources to the industry through a wide area of services.

Contact one of Marcum's regional representatives.




Federal, State and third party reimbursement represent the overwhelming payments received by the provider community. Marcum LLP has made it our business to maintain an updated knowledge of the changing reimbursement landscape both on a national and regional level. Through the firm we continue to assist the provider community in such area as:

  • Medicaid/Medicare cost report preparation.
  • Medicaid/Medicare compliance audit representation.
  • Regulatory credentialing recertification/certification.
  • Maintaining regulatory compliance.


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A Marcum LLP Newsletter



Healthcare Legislative Update

Rate Calculators
  • 2017 SNF Medicare Part A PPS RUG IV Rates

  • 2018 SNF Medicare Part A PPS RUG IV Rates

  • Medicare PPS Hospice Reimbursement Rates

  • Medicare PPS Home Health Agency Reimbursement Rates

  • Physician Fee Schedule Calculator



Healthcare Series

Related Healthcare News

HCPro published a definitive guide to SNF Medicare billing and reimbursement co-authored by Senior Manager Janet Potter.


With value-based purchasing transforming the long-term care billing landscape, billers need to bill appropriately to ensure they are not leaving money on the table. The ....

Gov. Rauner Plans for Illinois Unpaid Bills


Gov. Bruce Rauner announced plans to help pay off some of Illinois' $14 Billion in unpaid bills, by selling off bonds. As part of the ....

PPS Alert for Long-Term Care quoted Senior Manager Janet Potter in an article about prospective payment system rate increases for skilled nursing facilities.


As the Centers for Medicare and Medicaid Services (CMS) navigate what some may consider to be healthcare’s own modern-day Roman empire - a system undergoing ....

New Prior Authorization Procedures by eviCore


As of June 1, 2017 eviCore was selected by Blue Cross and Blue Shield of Illinois to manage the inpatient post-acute care prior authorization process ....

CMS Upgrades National Plan and Provider Enumeration System


In an effort to increase security and functionality, CMS has made upgrades to the National Plan and Provider Enumeration System (NPPES).

Updated State Operations Manual (SOM) Reflects the Requirements of Participation (RoP)


CMS recently posted an advance copy of the State Operations Manual which includes all the updates and changes secondary to the revised Requirements of Participation.

The New York Post quoted principal Michael D’Addio in an article about the Senate healthcare bill.


The Senate health-care plan closely resembles an earlier bill passed by the House, with both dismantling key provisions of ObamaCare.

TheStreet.com quoted Tax Principal Michael D’Addio in an article about tax reform and the American Health Care Act.


Investors and analysts are split on what's next for taxes in light of a renewed effort on Capitol Hill to tackle health care. The House ....

McKnight’s cited remarks by Senior Manager Marilyn Mines at the Leading Age Illinois conference, in an article about how poor documentation leads to Medicare denials.


Untimely certifications, missed or incorrectly billed Change of Therapy documentation, or a lack of documentation supporting a signed physician order for skilled therapy are among ....

Illinois' Medicaid Managed Care Program is Moving Statewide


Recently, the Illinois Department of Healthcare and Family Services (HFS) announced that the State will be transitioning to a statewide mandatory Medicaid managed care program ....

Massachusetts Determination of Need 2017 Revisions of 105 CMR 100


Effective January 27, 2017, the Massachusetts Department of Public Health implemented numerous revisions to the Determination of Need Program (DoN) regulations under 105 CMR 100.

American Health Care Act


House Republicans released their version of health care reform this week - the American Health Care Act (AHCA).

New Provider Complaint Portal Launched for Medicaid Managed Care


Last week, the Illinois Department of Healthcare and Family Services (HFS) launched a provider complaint portal to help providers resolve outstanding issues with individual Medicaid ....

Updates to the Payroll Based Journal (PBJ) Manual


CMS posted an update to the PBJ Policy Manual late 2016. Only a few of the areas have changes, but they are important ones ....

Spousal Impoverishment Amount Update


The Illinois Department of Healthcare and Family Services (HFS) issued a provider notice December 16, 2016 regarding Spousal Impoverishment.

Proposed Rule: Payment Resolution Policy for Medicaid Recipients


On November 28, 2016, the Illinois Department of Healthcare and Family Services (HFS) issued a proposed rule to assist in resolving payment denials related to ....

Supervisor Melissa Korey wrote about continued Medicare coverage for skilled nursing facility residents during holiday leave, for the December issue of HCPro’s Billing Alert for Long-Term Care.


In preparing for the holiday festivities, it is essential that friends and family understand that while their loved ones are in a nursing home, they ....

Supervisor Elizabeth Deak contributed an article on Medicare open enrollment for the November issue of HCPro’s Billing Alert for Long-Term Care.


Each year, Medicare's open enrollment period begins October 15 and ends December 7.

HCPro’s Billing Alert published an article by Senior Manager Marilyn Mines about the role of the billing dept. in long-term care quality assurance and performance improvement.


For years, there were two separate quality programs in long-term care required by CMS: Quality Assurance (QA) and Performance Improvement (PI).

Senior Manager Marilyn Mines wrote an article about the importance of communication in the skilled nursing facility environment, for Billing Alert for Long-Term Care.


Communication is known to be the Achilles' heel of the SNF. Many errors in the business office can be traced back to poor communication.

Janet Potter, advisory services senior manager, was quoted by McKnight's in article about Medicare compliance standards for skilled nursing facilities.


Skilled nursing providers should be prepared for managed care to drill down on Medicare Part A residents, creating the potential for major financial problems, a ....

Advisory Services Senior Manager Janet Potter advises Skilled Nursing Facilities to have a strategy for integrating Medicare’s PEPPER data into their corporate compliance programs, in an article for HCPro’ s Billing Alert for Long-Term Care.


Every spring, CMS makes available the Program for Evaluating Payment Patterns Electronic Report (PEPPER) for SNFs. The agency offers variant reports for a number of ....

Minimizing Sales & Use Tax Obligations of Illinois Healthcare Facilities

Service providers in the State of Illinois who transfer items of tangible property incident to the services they sell are generally subject to the Service ....

CT Association of Residential Care Home


It's that time of year again. The time when the days begin to get shorter and the greatly awaited rate computation reports start arriving in ....

Michael D'Addio, Tax & Business Services Principal, Quoted in Long Island Business News Article, "The ACA Meets the IRS."


This year, for the first time, the health insurance taxpayers carry may directly affect the size of the tax refund they receive from the Internal ....

New IRS Publication Explains How Individuals Report Health Care Coverage on 2014 Returns


The IRS has recently issued new Publication 5187 (Health Care Law: What's New for Individuals and Families) to cover some of the tax provisions of ....

Matthew Bavolack, National Healthcare Practice Leader, Quoted in Hartford Business Journal Article, "One CT Nursing Home's Path Out of Medicaid Morass."


Connecticut's reimbursement rate for its neediest nursing-home patients on Medicaid has risen just 1.2 percent in the seven years since the last increase of 2.9 ....

Article by David Appel, Tax & Business Services Partner, "Planning Your Estate Now Can Prevent Problems in the Future" Featured in the South Florida Hospital News and Healthcare Report


No matter what your situation, there's no time like the present to make an estate plan. Whether you have young children, are retired, or have ....

Article by David Glusman, Advisory Services Partner, "Co-Management: A Win-Win Model for Hospital and Physician Relationships," Featured in Philadelphia Business Journal


A recent announcement by Independence Blue Cross (IBC) emphasizes the importance of hospitals and doctors continuing to develop win-win mechanisms for working together in response ....

Matthew Bavolack, National Healthcare Practice Leader and Frank Miceli, New England Healthcare Practice Leader, Featured in Hartford Business Journal Article, "Taming Long-Term Care's Looming Crisis."


Q&A talks about the challenges facing the long-term care industry with Marcum LLP's Matthew S. Bavolack, principal and national healthcare practice group leader and Frank ....

Experts Predict Perfect Storm in Long-Term Care Industry at Inaugural Marcum Long-Term Care Symposium

The long-term care industry will be challenged by exploding demand for care by a rapidly aging population, just as a massive shift from private to ....

Marcum LLP Announces Inaugural Long-Term Care Symposium

Marcum LLP a top national accounting and advisory firm, will host the Firm's first Long-Term Care Symposium on May 5 at the Mohegan Sun ....

Marcum Healthcare Reform Expert Responds to New Delay in Large Employer Mandate Under Affordable Care Act

Michael F. D'Addio, a Principal in the New Haven, Connecticut office of Marcum LLP and co-manager of the Firm's national Healthcare Reform Task Force, responded ....

Michael D'Addio, Tax & Business Services Principal, Quoted in CNBC.com Article, "The Obamacare Tax Deconstructed."


Several developments related to the Affordable Care Act will be hitting many filers in the pocketbook this tax season, but they need to keep an ....

Michael D'Addio's Article "Obamacare Forces Changes in Health Spending Accounts" Featured in The Hartford Business Journal


Since its enactment, the Affordable Care Act has made many changes to the rules for deducting medical expenses. Several provisions that go into effect this ....

Michael D'Addio, Tax & Business Services Principal, Quoted in TheStreet Network Article "The Rich and Sick Taxed to Pay for Health Care Reform"


Last week, the Treasury Department and Internal Revenue Service (IRS) issued final regulations on the individual shared responsibility provision of the Affordable Care Act (ACA) ....

David Glusman, Advisory Services Partner, Quoted in Philadelphia Business Journal Article "Renaissance Growing as ACO Provider"


Marc Malloy, after being invited to testify before the Senate Finance Committee, called up his dad earlier this year to brag a little.

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Matthew  Bavolack

Healthcare Services Leader
New Haven, CT



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