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Hospice Audit Series: Insights for Winning at Administrative Law Judge (ALJ) Hearings, Part I
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On June 27, 2024, the Supreme Court of the United States released its opinion in SEC v. Jarkesy, a case involving a Securities and Exchange Commission (“SEC”) enforcement action for civil penalties against an investment...more
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
HHS’s Office of Medicare Hearings and Appeals (OMHA) has long faced a backlog in Medicare appeals to Administrative Law Judges (ALJs). In an effort to address this backlog, OMHA established a Settlement Conference...more
On June 28, 2016, the U.S. Department of Health and Human Services (HHS) released a series of regulatory changes in the Notice of Proposed Rule Making (NPRM) designed to curtail the massive backlog of Medicare claim appeals....more
On October 15, 2015, the Office of Medicare Hearings and Appeals (“OMHA”) conducted a teleconference to address Phase II of the Settlement Conference Facilitation (“SCF”) Pilot, effective October 1, 2015. SCF, launched in...more
In its Work Plan for Fiscal Year 2012, the Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) announced it would begin reviews of Medicare payments to hospitals to determine compliance...more
I. SHPDA Administrative Report - AL2015-022, Gulf Health Hospitals, d/b/a Thomas Hospital, Daphne, AL: Proposes to establish a freestanding emergency department (FED). The project was approved with stipulation of...more
If you are one of the many health care providers wanting to appeal a Medicare contractor’s reimbursement decision, you may need to be prepared for a long wait. Over the last few years, the backlog of appeals to the...more
On June 3, 2015, the Senate Finance Committee passed an original bill that aims to streamline and improve the Medicare Audit and Appeals Process. The Medicare appeals process has recently faced scrutiny from industry leaders...more
The Office of Medicare Hearings and Appeals (OMHA) has issued a Memorandum to OMHA Medicare appellants announcing a temporary stay, effective for cases filed on or after July 15, 2013, in the assignment of new requests for...more