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.
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By Frank Miceli, Partner, Assurance Services
The Hospital Value-Based Purchasing Program is entering its seventh year and is one of many programs Medicare has established to reimburse providers for quality instead of quantity.
By Urszula Skarzynski, Manager, Assurance Services
On November 29, 2018, the Department of Health and Human Services Health Resources and Services Administration issued a final rule for the 340B drug discount program, which will launch on...
Since April 2018, the Centers for Medicare and Medicaid Services has issued two change requests relating to the Medicare cost report e-filing process - CR transmittal number R2075OTN on April...
By Gregory Marazita, Partner, Assurance Services
The long-awaited effective date for the new guidance on financial reporting for not-for-profit organizations under ASU 2016-14, Not-for-Profit Entities Topic 958 Presentation of Financial Statements of Not-for-Profit Entities, is upon...
By Yasmeen Elhaj, Supervisor, Advisory Services
On October 12, 2018, the Centers for Medicare and Medicaid Services published the rates for Medicare Parts A and B premiums and deductibles.
By Yasmeen Elhaj, Supervisor, Advisory Services
The Skilled Nursing Facility Value-Based Purchasing Program is an incentive payment program for SNFs paid under the Prospective Payment System, which focuses on the quality care delivered to Medicare recipients....
In May 2014, the Financial Accounting Standards Board changed the landscape for revenue recognition. Accounting Standards Update 2014-09, Revenue from Contracts with Customers, created a new principle-based framework to determine...
By David Glusman, Partner, Advisory Services
In most of the business world, fair market value is an established term indicating what value a willing buyer and a willing seller in a hypothetical transaction would arrive at...
By Christopher Jackson, Partner, Assurance Services
Over the years, I have seen several instances where companies have pushed the envelope in structuring leases to keep liabilities for leased assets off the books by classifying them as...
By Steven Lavenda, Partner, Advisory Services
The Center for Medicare and Medicaid Services recently issued a new Office of Inspector General work plan which intends to provide more oversight of nursing facilities staffing levels.
By Matthew Bavolack, Healthcare Services Leader
Who remembers Medicare cost-based reimbursement? If you raised your hand, I guess like me, we are all dating our years of experience in the healthcare industry.
By Scott Manson, Partner, Advisory Services
On July 12, 2018, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year 2019 proposed rule in the Federal Register.
By Scott Manson, Partner, Advisory Services
On August 6, 2018, the Centers for Medicare and Medicaid Services (CMS) released the fiscal year 2019 final payment rule.
By Stephen Bernier, Manager, Advisory Services
In May 2017, the Centers for Medicare and Medicaid Services released a proposal for a new payment model for Medicare patients staying in skilled nursing facilities.
By David Glusman, Partner, Advisory Services
The Federal Department of Justice and the Office of Inspector General at the U.S. Department of Health and Human Services have been fighting fraud in...
By Steven Lavenda and the Marcum Midwest Healthcare Team
In May, the Justice Department placed a $5,000 civil penalty on a Norwood, MA, nursing facility for denying admission to a patient who had been...
By Gina Lucibello, Supervisor, Tax & Business Services
The Tax Cuts and Jobs Act (TCJA) contains a numbers of provisions that could affect the operations of nonprofit hospitals.
By Megan Budd, Senior Manager, Assurance Services
Employee benefit plans use service organizations to provide a variety of functions, including, participant recordkeeping, trust reporting, plan testing, claims processing, and payroll.
By Joshua Bloom, Supervisor, Assurance Services
If your organization receives federal funding through Medicare and Medicaid, you should know about the exclusion listings. Not knowing about the exclusion listings can cost your organization a significant...
By Gary Smith, Director, Assurance Services
In today's constantly changing skilled nursing facility environment, nursing homes must find efficient and effective ways to manage the patient process, from admissions to discharge, in order to maximize shrinking...
By Frank Miceli, Partner, Assurance Services
The accounting for Continuing Care Retirement Communities has always been a highly specialized area that requires a significant level of estimation and subjectivity.
By Darlene Angelucci, Director, Assurance Services
In an attempt to obtain a contract with customers (such as patients, residents or members), healthcare entities incur incremental costs.
By Rick Meeske, Senior, Advisory Services
2017 was a breakthrough year for blockchain, although this didn’t become evident until late in the year when the market for cryptocurrencies suddenly heated up.
By Marilyn Mines, Senior Manager, Advisory Services
After several years of waiting and wondering, the finalized SNF ABN is here. CMS published the updated version on Thursday, February 1, 2018.
By Taryn Smith, Manager, Tax & Business Services & Igor Bochenkov, Director, Tax & Business Services
The term healthcare industry encompasses a diverse range of organizations, entity classifications and services provided. Each member of this industry needs to take stock of exactly what services and products...
By Marilyn Mines, Senior Manager, Advisory Services
The New Year has started with numerous new, revised, and revisited regulations and requirements - some starting this year and others that began in late-2017.
By David Glusman, Partner, Advisory Services
A recent headline caught our attention: local nursing homes agreed to pay up to $6.9 million to settle kickback and fraud allegations under the Medicare and Medicaid programs.
By Marilyn Mines, Senior Manager, Advisory Services
On November 17, 2017, the Centers for Medicare & Medicaid Services published the rates for Medicare Parts A and B premiums and deductibles.
By Megan Budd, Senior Manager, Assurance Services
Not-for-profit organizations are seeing a sharp increase in the incidence of fraud due a “perfect storm” of threats derived from the unique characteristics of a NFP organization, the availability of...
By Marilyn Mines, Senior Manager, Advisory Services
The Center for Medicaid and Medicare Services recently released the final Nursing Home Prospective Payment System decisions described in the published FY2018 Final Rule.
By Christopher Jackson, Partner, Assurance Services
The effective date of Financial Accounting Standards Board Accounting Standards Update 2014-09, Revenue from Contracts with Customers ("ASC 606"), is quickly approaching.
By Stephen Bernier, Manager, Advisory Services
The Centers for Medicare and Medicaid Services have plans to roll out three major initiatives beginning October 1, 2018.
By Drew Bernstein, Co-Managing Partner, Marcum Bernstein & Pinchuk, LLP
Over the past five plus years the M&A markets in the U.S. have been at a feverish pace through the continuum while the activity may have slowed in 2017 it's...
By Rick Meeske, Senior, Advisory Services
Recently, the Center for Medicare and Medicaid Services developed a new strategy entitled Targeted Probe and Educate (TPE) to tackle the issue of backlogged appealed and denied claims.
By Rick Meeske, Senior, Advisory Services
Personal identity theft is becoming a bigger threat, especially to seniors, who are more frequently becoming victims to Medicare identity theft and fraud.
By Janet Potter, Senior Manager, Advisory Services
On May 4, 2017, the Centers for Medicare and Medicaid Services released two proposed rules for skilled nursing facilities.
By Stephen Bernier, Manager, Advisory Services
Anyone in the healthcare arena who has experienced a compliance audit knows that if you receive money from the Federal or State government, they are...
By Justin Nepo, Partner, Assurance Services
It happens every year; the client and auditor have this fairy-tale dream that this will be the year that the perfect audit is going to occur.
By Janet Potter, Senior Manager, Advisory Services
Recently the Centers for Medicare and Medicaid Services (CMS) updated the CMS-R-131 (ABN) form.
By Michael D'Addio, Principal, Tax & Business Services
The House of Representatives passed by a narrow margin the American Health Care Act (AHCA).
By Gary Smith, Director, Assurance Services
It seems like every day we sit down to read the news and we see another case of fraud being reported, be it accounting fraud, misappropriation of assets, or cybercrime.
By Elizabeth Deak, Supervisor, Advisory Services & Melissa Korey, Supervisor, Advisory Services
Medicare and other commercial payers are putting pressure on providers' bottom lines due to the influx of claim reviews and appeals.
By James Kennedy, Partner, Assurance Services
The not-for-profit sector has experienced significant change in recent years with the passage and implementation of the Patient Protection and Affordable Care Act (ACA) in 2010 and funding cuts at...
By Rick Meeske, Senior, Advisory Services
On February 3, 2017, the Department of Health and Human Services (HHS), Office of the Assistant Secretary for Financial Resources, updated its Civil Monetary Penalties...
By Darlene Angelucci, Senior Manager, Assurance Services
With the current changing healthcare landscape, managing the cost of patient care has become a top priority for every hospital and healthcare delivery system.
By Frank Miceli, Partner, Assurance Services
The revenue recognition standard, ASU 2014-09 – Revenue from Contracts with Customers, was originally issued in May 2014 and subsequently amended for extension of adoption dates and clarifications.
By Bonny Kohr, Senior Manager, Advisory Services
On January 13, 2017 CMS published the final rule which revises the Medicare and Medicaid Program: Conditions of Participation (CoP) for home health agencies that...
By Janet Potter, Senior Manager, Advisory Services
Beginning March 8, 2017, hospitals and critical access hospitals will be required to issue the Medicare Outpatient Observation Notice to Medicare beneficiaries who are receiving...
Comprehensive Care for Joint Replacement (CJR) is a relatively new bundled payment model that focuses on reducing costs of Lower Extremity Joint Replacement Services (LEJRS) under MS-DRG 469 and MS-DRG...
By Janet Potter, Senior Manager, Advisory Services
On December 8, 2016, the Medicare Payment Advisory Commission (MedPAC) met to discuss the future of skilled nursing facility (SNF) prospective payment system (PPS) payments.
By Marilyn Mines, Senior Manager, Advisory Services, Bonny Kohr, Senior Manager, Advisory Services & Janet Potter, Senior Manager, Advisory Services
The annual Office of Inspector General (OIG) work plan was released on November 10, 2016. If you haven’t already done so, it is time to begin preparing your organization...
By Marilyn Mines, Senior Manager, Advisory Services
Beginning March 20, 2017, there is a requirement for prior authorization for motorized wheelchairs with the HCPCS of K0856 and K0861. This March date marks the first phase of...
By Justin Nepo, Partner, Assurance Services
On June 23, 2014, the State of New Jersey passed new legislation which may have gone unnoticed by most, but was significant for owners of home health services businesses. The...
By Melissa Korey, Supervisor, Advisory Services
The Centers for Medicare and Medicaid Services (“CMS”) just released the new Medicare premium, coinsurance, and deductible rates for 2017.
By Melissa Korey, Supervisor, Advisory Services
On November 15, 2016, the Centers for Medicare and Medicaid Services ("CMS") published the Physician Fee Schedule (PFS) final rule for calendar year ("CY") 2017...
Marcum LLP's Midwest Healthcare Symposium is a one-day learning event offering valuable educational sessions, networking with local peers, and the opportunity to earn 4.5 hours of CE and 5.5 hours...
By Janet Potter, Senior Manager, Advisory Services
On Monday, October 31, 2016, the Centers for Medicare and Medicaid Services (CMS) announced the new Recovery Audit Contractors (RACs) for Medicare fee-for-service.
By Janet Potter, Senior Manager, Advisory Services
Open enrollment for Medicare beneficiaries runs each year from October 15 through December 7. The weeks following open enrollment are even more critical for Medicare...
By Stephen Bernier, Manager, Advisory Services
The Medicare Shared Savings Program, which was established under Section 3022 of the Affordable Care Act, is intended to reward service providers and suppliers for high quality care while reducing...
By Melissa Korey, Supervisor, Advisory Services
The Centers for Medicare and Medicaid Services (CMS) is being mandated by the Medicare Access and CHIP Reauthorization Act (MACRA) to remove social security numbers...
By Yasmeen Elhaj, Senior, Advisory Services
The U.S. Department of Health and Human Services Office for Civil Rights (OCR) has recently completed a Health Insurance Portability and Accountability Act of 1996...
By Frank Miceli, Partner, Assurance and James Kennedy, Partner, Assurance
On August 18, 2016, the Financial Accounting Standard Board ("FASB") issued Accounting Standards Update (ASU) 2016-14, Presentation of Financial Statements of Not-for-Profit Entities. Not-for-profit entities (NFPs) have been preparing their financial statements...
By Joshua Banach, Senior Manager, Advisory Services
On August 5, 2016, The Centers for Medicare & Medicaid Services (CMS) released the fiscal year 2017 final payment rule regarding Medicare hospice payment and...
By Bonny Kohr, Senior Manager, Advisory Services
The Centers for Medicare and Medicaid Services (CMS) learned that on August 10 and 11, 2016 incorrect death terminations for over 3,000 beneficiaries were processed,...
By David Glusman, Partner, Advisory Services
In July, the Centers for Medicare and Medicaid Services (CMS) significantly expanded its payment reform efforts by proposing bundled payment episodes for cardiovascular and orthopedic services.
By Melissa Korey, Supervisor, Advisory Services
Last spring, the Centers for Medicare and Medicaid Services (CMS) posted the application for an exception to the 3-day inpatient hospital stay requirement for Skilled...
By David Glusman, Partner, Advisory Services
There are many new things happening with regard to the Health Insurance Portability and Accountability Act of 1966 (HIPAA), not least of which is a...
By Matthew Bavolack, National Healthcare Industry Group Leader
Over the past few years, the pace of change in the healthcare industry has been daunting, making it almost impossible for providers to keep up with all
aspects of the transformation.
By Janet Potter, Senior Manager, Advisory Services
On April 25, 2016, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register the skilled nursing facility (SNF) prospective payment system (PPS)...
By Marilyn Mines, Senior Manager, Advisory Services
The Centers for Medicare and Medicaid Services (CMS) is being funded by the Centers for Disease Control and Prevention (CDC) to undertake a 3-year pilot...
Healthcare organizations need to be aware of ongoing and projected employment shortages for physicians and nurses, which have resulted in increasing demand for outsourced services.
Bonny Kohr, Senior Manager, Advisory Services
Beginning October 3, 2016, Hospice Notices of Election (NOEs) submitted to the Medicare Administrative Contractor (MAC) without a principal diagnosis will not be processed and will be returned to the...
By David Glusman, Partner, Advisory Services
The long-term sustainability of physician practices is directly tied to their revenue, and that means physicians must have a thorough understanding of their current and future revenue sources and their...
By Bonny Kohr, Senior Manager, Advisory Services
Palmetto GBA the Jurisdiction M Medicare Administrative Contractor (MAC) for home health has updated the Type II Diabetes Local Coverage Determination (LCD - L35132) once again.
By David Murcko, Manager, Assurance Services
Planning and forecasting financial budgets for hospitals or physicians practices is difficult in any period but especially in this presidential election year. The election results may dramatically...
By Janet Potter, Senior Manager, Advisory Services & Bonny Kohr, Senior Manager, Advisory Services
On April 28, 2016, the Centers for Medicare and Medicaid Services (CMS) published in the Federal Register the proposed hospice wage index and payment rule update along...
By Darlene Angelucci, Senior Manager, Assurance Services
Today the method by which healthcare is structured, delivered and reimbursed is on the precipice of profound and far-reaching change. According to Dr. Jim Weinstein, president and CEO of Darmouth-Hitchcock...
By Gregory Marazita, Partner, Assurance Services
On February 25, 2016, the Financial Accounting Standards Board (FASB) issued Accounting Standards Update (ASU) 2016-02, Leases. The new standard creates Topic 842, Leases, in the FASB Accounting Standards Codification...
By Janet Potter, Senior Manager, Advisory Services
It is time once again for skilled nursing facilities (SNFs) and hospice agencies to access their Program for Evaluating Payment Patterns Electronic Report (PEPPER). This annual report is a great...
By Janet Potter, Senior Manager, Advisory Services
As promised, the Office of Civil Rights (OCR) recently announced it will begin Phase 2 of its HIPAA privacy, security and breach notification audits later this year. The majority of...
By Matthew Bavolack, Principal, Healthcare Industry Group Leader
ACOs, bundled payments, money follows the person, sequestration... Today's healthcare market continues to be reimbursement challenged. More so today than ever, it is imperative that providers properly...
By Tom Reinke, Manager, Advisory Services
Leading healthcare systems are moving away from productivity- based physician compensation arrangements to new models that are consistent with the payment reforms being implemented by CMS and...
By Marilyn Mines, Senior Advisor, Advisory Services
Centers for Medicare and Medicaid Services (CMS) recently announced that the Quality Improvement and Evaluation Systems (QIES), which is used to submit required assessment information to the...
By Bonny Kohr, Senior Manager, Advisory Services
The Centers for Medicare and Medicaid Services (CMS) has established a prior authorization program for certain DMEPOS, effective February 29, 2016. The purpose of the prior authorization...
By Marilyn Mines, Senior Manager, Advisory Services
The Office of the Inspector General (OIG) publishes a work plan every year. As a result of the various in-depth studies OIG conducts, millions of dollars are...
By James Kennedy, Partner, Assurance Services
Gregory Marazita, Partner, Assurance Services
Eric Saunders, Director, Assurance Services
The Financial Accounting Standards Board ("FASB") has been working on a financial statement project that may result in a number of changes to accounting standards and financial reporting for non-profit...
By Matthew S. Bavolack, National Healthcare Industry Group Leader
Welcome to Marcum LLP's first addition of “Trending in Healthcare”, a quarterly newsletter designed to provide clients, referral sources and colleagues an update on trends in the healthcare market place....
By Marilyn Mines, Senior Manager, Advisory Services
Fiscal year 2016 has barely begun and the draft for Minimum Data Set (MDS) v1.14.0 is already posted. Normally, this would not be discussed so early in the fiscal...
Marcum LLP is one of the largest independent public accounting and advisory services firms in the nation, with offices in major business markets throughout the U.S., as well as Grand Cayman, China and Ireland.
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