Lanchi Nguyen Bombalier

Lanchi Nguyen Bombalier

Arnall Golden Gregory LLP

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The Devil’s in the Details: Hospice Providers Face Claim Denials for Election Statement Technicalities

Since the Centers for Medicare & Medicaid Services (“CMS”) paused much of its audit activity during the COVID Public Health Emergency, the most recent rounds of Medicare audit activity may represent the first “look” at the...more

2/29/2024  /  Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Home Health Care , Hospice , Medicare , Medicare Administrative Contractors (MAC) , Targeted Probe and Education (TPE) audit

A Midsummer’s Review – Cybersecurity Is the Word: HIPAA Enforcement and Guidance Trends

Summer is in full swing, but the U.S. Department of Health and Human Services Office for Civil Rights (“OCR”) is doing anything but taking a vacation from HIPAA. In May and June, OCR issued five resolution agreements...more

7/27/2023  /  Compliance , Corrective Action Plans (CAPs) , Cybersecurity , Health Care Providers , Health Insurance Portability and Accountability Act (HIPAA) , OCR , Patient Privacy Rights , PHI , Popular , Telehealth

HIPAA Compliance Alert: OCR Anticipates the End of Enforcement Discretion for Telehealth Use

A popular saying is that it takes 21 days to form a habit and about 66 days on average for a behavior to become automatic. If that is correct, the three-year period of unprecedented waivers and flexibilities in the provision...more

5/4/2023  /  Coronavirus/COVID-19 , Health Care Providers , Health Insurance Portability and Accountability Act (HIPAA) , OCR , Public Health Emergency , Telehealth , Telemedicine

Reporting Deadline for 2022 Small HIPAA Breaches: March 1, 2023

With 2023 underway, healthcare providers and other “covered entities,” as defined under the Health Insurance Portability and Accountability Act (“HIPAA”), should be mindful of the upcoming annual reporting deadline for small...more

1/26/2023  /  Covered Entities , Department of Health and Human Services (HHS) , Health Care Providers , Health Insurance Portability and Accountability Act (HIPAA) , HIPAA Breach , OCR

Brace Yourself: OCR HIPAA Enforcement for Dental Practices Continue to Focus on Patient Right of Access

Recently, the U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) announced three more resolution agreements settling alleged violations of the HIPAA right of access. These agreements bring...more

10/6/2022  /  Enforcement Actions , Health Care Providers , Health Insurance Portability and Accountability Act (HIPAA) , Medical Records , OCR , Records Request , Right of Access

Preparing for Home Healthcare in a Post-COVID World: What Will Stay and What Will Go

As the COVID-19 Public Health Emergency (“PHE”) approaches the three-year mark, what initially seemed like the “new” normal seems closer to just plain normal for many healthcare providers. As a result, while the Department of...more

9/8/2022  /  Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Health Care Providers , Home Health Care , Public Health Emergency

COVID-19 Pet Boom Puts Spotlight on Veterinary Investment Opportunities

More than 23 million American households — nearly 1 in 5 nationwide — adopted a pet during the COVID-19 pandemic, according to the American Society for the Prevention of Cruelty to Animals (ASPCA). The increasing rates of pet...more

6/8/2022  /  Health Care Providers , Industry Consolidation , Investment Opportunities , Investors , Pets , Private Equity , Regulatory Requirements , Veterinarians

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

The “Vacation” Is Over: CMS Resumes Hospice Targeted Probe and Educate Audits

On September 1, 2021, as hospice providers continue to grapple with the demands of the ongoing pandemic, the Centers for Medicare & Medicaid Services (CMS) ended its temporary suspension of the Targeted Probe and Educate...more

9/8/2021  /  Audits , Centers for Medicare & Medicaid Services (CMS) , Hospice , MACs

OIG to Audit Telehealth Services Provided During Pandemic by Part B and Home Health Providers

The U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) recently updated its 2021 Work Plan in January to include audits of Medicare Part B and home health telehealth services by OIG’s Office...more

2/3/2021  /  Audits , Department of Health and Human Services (HHS) , Health Care Providers , Home Health Care , Medicare Part B , OIG , Public Health Emergency , Telehealth

The Year Ahead: Telehealth in 2021 - Will Auld Acquaintance Be Forgot?

As the end of 2020 approaches, the melody to “Auld Lang Syne” inevitably comes to mind. The meaning of this song is particularly appropriate as we consider what will stay, and what will pass when it comes to telehealth in...more

12/10/2020  /  Centers for Medicare & Medicaid Services (CMS) , Coronavirus/COVID-19 , Department of Health and Human Services (HHS) , Health Care Providers , Medicare , Public Health Emergency , Telehealth , Telemedicine

OIG Weighs-In on the Review of Extrapolated Overpayments in the Medicare Appeals Process

The financial stakes are often very high for providers when statistical sampling and extrapolation is used to calculate an alleged Medicare overpayment. In post-payment audits involving extrapolation, an actual claims denial...more

9/9/2020  /  Appeals , Extrapolation , MACs , Medicare , OIG , Overpayment , QICs

AGG Hospice Quarterly 2020

CMS Announces Hospice Capitation Rates for Medicare Advantage - The U.S. Centers for Medicare and Medicaid Services (CMS) recently released the capitation rates for hospice care through the value-based insurance design...more

3/30/2020  /  Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Hospice , Medicare , Medicare Advantage , OIG

Medicare Establishes Criteria to Allow Hospices to Accept Prescription Orders from Physician Assistants

Exactly one year after the Bipartisan Budget Act of 2018 redefined the statutory definition of “attending physician” to allow physician assistants (PAs) to serve as a hospice attending physician, the Centers for Medicare &...more

1/8/2020  /  Health Care Providers , Hospice , Medicare , Physician Assistants

OIG’s Latest Report Continues to Build a Case for Increased Scrutiny of Emergency Ambulance Transports

If the looming threat of the Review Choice Demonstration which recently began in Illinois was not sufficient to make home health agencies a little anxious, the U.S. Department of Health and Human Services, Office of Inspector...more

9/25/2019  /  Department of Health and Human Services (HHS) , Health Care Providers , Home Health Agencies , OIG

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

OIG Increases Scrutiny of Home Health Agencies

If the looming threat of the Review Choice Demonstration which recently began in Illinois was not sufficient to make home health agencies a little anxious, the U.S. Department of Health and Human Services, Office of Inspector...more

6/19/2019  /  Health Care Providers , Home Health Agencies , Home Health Care , OIG

Summary Recap and Key Takeaways from AHLA’s Medicare and Medicaid Payment Issues Conference

Every year, health lawyers, providers, consultants, and government experts from across the country convene in Baltimore for the American Health Lawyers Association’s Institute on Medicare and Medicaid Payment Issues, the most...more

4/10/2019  /  AHLA , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Health Care Providers , Medicaid , Medicare , OIG , OMHA

OIG Issues Report on Hospice Program Vulnerabilities

In July 2018, the Department of Health and Human Services’ Office of Inspector General (OIG) issued a report entitled, Vulnerabilities in the Medicare Hospice Program Affect Quality Care and Program Integrity...more

8/9/2018  /  Centers for Medicare & Medicaid Services (CMS) , Health Care Providers , Hospice , Medicare , OIG , Skilled Nursing Facility

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

CMS Plans To Eliminate Home Health Agency Subunits in 2018

On November 17, 2017, the Centers for Medicare and Medicaid Services (CMS) issued a Memorandum to State Survey Agency Directors outlining the process by which Medicare will eliminate existing Home Health Agency (HHA)...more

12/6/2017  /  Centers for Medicare & Medicaid Services (CMS) , Conditions of Participation (CoP) , Health Care Providers , Home Health Agencies , Home Health Care

The Office for Civil Rights Issues New HIPAA Opioid Guidance Document

In the wake of the presidential declaration of the opioid crisis as a national public health emergency, the Department of Health & Human Services (HHS) Office for Civil Rights (OCR) released a new guidance document on October...more

11/30/2017  /  Department of Health and Human Services (HHS) , Health Care Providers , Health Insurance Portability and Accountability Act (HIPAA) , Medical Records , OCR , Opioid

Texas Revises Change of Ownership (CHOW) Requirements for Certain Healthcare Provider Types

The Texas Health and Human Services Commission, on behalf of the Department of Aging and Disability Services (DADS), has adopted revised regulations that impact the Change of Ownership (CHOW) process and requirements for...more

9/26/2017  /  Change of Ownership , Department of Health and Human Services (HHS) , Health Care Providers , Home Health Agencies , Nursing Homes
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Updated: Dec 28, 2021:

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Privacy Officer
JD Supra, LLC
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Sausalito, CA 94965

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