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Capital campaigns can be game changers for nonprofits, enabling bold investments in infrastructure, programs, and long-term growth. Whether you're building a new facility, expanding services, or upgrading technology, a capital campaign aligns fundraising with your strategic vision. 

The FDIC's Quarterly Banking Profile for quarter one 2025 reports the performance for the 4,022 community banks evaluated.

Healthcare organizations are currently facing growing financial challenges and experiencing high staff turnover. Recruiting a compliance officer may prove challenging due to the unavailability of experienced professionals or concerns about salary and fringe expenses. Depending on a healthcare organization’s fiscal health, consideration might be given to downsizing the compliance department. This article offers guidance to healthcare administrators as they ponder several compliance-related what-if scenarios.

CMS recently extended the deadline for the mandatory SNF provider enrollment off-cycle revalidation to January 1, 2026.  

July is National Parks and Recreation Month, and it’s the perfect time to celebrate the people who transform everyday spaces into places of joy, connection, and belonging. To highlight this year’s theme, ‘Build together, play together,’ members of BerryDunn’s Parks, Recreation, and Libraries team share stories of projects that helped communities thrive—and the personal ways they embrace play in their own lives. 

Signed into law by President Trump on July 4, 2025, the One Big Beautiful Bill Act (OBBBA) marks a significant step forward in addressing America’s growing need for affordable housing. With the demand for low-cost units far outpacing supply nationwide, the legislation offers targeted solutions aimed at making development more feasible and sustainable.

On July 4, 2025, the One Big Beautiful Bill Act (OBBBA) was signed into law. This article summarizes relevant key provisions that impact tax-exempt organizations. 

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. For the latest installment of our board leadership series, BerryDunn HR Generalist Maddie Stevens, shares insights on onboarding, engaging, and fostering connections for new employees, as well as leveraging generational gaps in the workforce.  

Tariffs remain a significant cost factor for US importers and exporters. Understanding and leveraging trade programs is more critical than ever. One underutilized but highly valuable strategic tool is duty drawback. 

On July 1, 2025, Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) transitioned from cost report-based to claim-based Medicare reimbursement for influenza, pneumococcal, COVID-19, and Hepatitis B vaccines. This important policy change enables real-time payment, improving cash flow and making vaccine administration more financially viable for health centers and clinics. 

Artificial intelligence applications in healthcare have become ubiquitous and pervasive, and their adoption is accelerating. A recent American Medical Association survey disclosed physicians’ confidence in AI’s advantage for patient care is on the rise and their enthusiasm for its use is increasing. 

The "Big Beautiful Bill" introduces a new savings vehicle for American families called the Trump Account. This novel provision has largely been overshadowed by other headline items including the SALT cap—and perhaps understandably so. This article will explain what these accounts are, how they would work, and their tax implications, so that if the legislation passes, you can be informed on whether they fit into your family's financial future.

The Medicare Payment Advisory Commission’s (MedPAC) June 2025 Report to Congress highlights critical developments in Medicare Advantage (MA). Several key insights emerged with important implications for home health and supplemental benefit policy. 

Newly appointed to lead BerryDunn’s Healthcare Practice Group, Lisa Trundy-Whitten is closely attuned to the healthcare industry. From challenges faced by healthcare organizations to the solutions BerryDunn’s experts can provide, Lisa shares her vision for the team as she takes the helm, as well as thoughtful insights for today’s healthcare leaders. 

As artificial intelligence (AI) becomes increasingly woven into nonprofit operations, boards are stepping into a new and critical role. Traditionally focused on mission oversight and fiscal responsibility, today's boards must also shape how AI is introduced, governed, and aligned with the organization’s values. Below are the seven most important actions a board can take to ensure responsible and strategic AI implementation. 

For healthcare finance professionals, Artificial Intelligence (AI) has become a strategic imperative. With a strong implementation strategy, AI can be implemented to prevent and manage denials, reducing the financial and administrative pressures on an organization. 

The debate and negotiations over tax reform are taking shape in the United States Congress. The United States Senate is reviewing the ‘One Big Beautiful Bill Act’ (OBBBA) passed by the US House of Representatives in late May. The House-passed legislation contains meaningful tax reforms with potentially significant impact to businesses and individuals.

Credit, purchase, and debit cards each offer convenience for small-dollar purchases, but carry varying levels of risk. Strong internal controls are essential to prevent fraud, misuse, and compliance violations.

In the complex world of international trade, businesses are constantly seeking ways to optimize their supply chains and reduce costs. One often-overlooked strategy that can yield significant savings is the use of first sale declarations.  

Nonprofit leaders must assess the risks and strategically position their organizations to adapt to changing funding landscapes. This article outlines key steps to help your organization proactively evaluate funding vulnerabilities, mitigate risks, and plan for sustainable operations. 

CAPRA accreditation is more than a “stamp of approval” for parks and recreation agencies. It is the foundation of a well-run parks and recreation department, offering proof that an agency is operating at the highest standards. In a competitive municipal environment where funding is tight and priorities shift, accreditation gives departments the credibility they need to advocate for resources and drive innovation. 

The proposed “One Big Beautiful Bill Act” includes several provisions that would directly impact tax-exempt organizations. BerryDunn’s experts provide a breakdown of how the bill could affect nonprofits.

Federally Qualified Health Centers (FQHCs) face a perfect storm—level grant funding, shrinking 340B drug pricing savings, and rising expenses. Staying sustainable requires identifying ways to maximize operations and revenue while controlling costs. That’s where site- and program-specific accounting become essential. 

The proposed $880 billion cuts to Medicaid, along with recently imposed tariffs and funding freezes, have placed healthcare organizations directly in the crosshairs of federal funding reductions. The result is an unprecedented threat that would profoundly affect the financial stability of organizations providing care.

The US Department of Health and Human Services Office of Inspector General has been actively enforcing healthcare compliance and fraud prevention in 2025. Are you ready? 

When it’s time to change auditors, it’s important to find a firm that feels like a long-term partner. Start by asking the right questions up front. 

With default federal student loan collections now resumed by the Department of Education, higher education institutions and other effected nonprofits need a strategy to ensure compliance. 

After an intense overnight session, the US House of Representatives narrowly passed the "One Big Beautiful Bill Act" with a 215-214 vote, marking a significant milestone in fiscal policy reform. The bill, which now heads to the Senate for further consideration, proposes extensive tax changes alongside broader regulatory shifts. While House Republicans and the current administration champion the bill as a legislative victory, Democratic opposition remains strong, and modifications are expected before it reaches the president’s desk.

Public health agencies have a powerful opportunity to inspire the next generation of professionals to join the governmental workforce. To build a pipeline of committed talent, agencies must take proactive steps—establishing dynamic mentorship programs, creating hands-on internship opportunities, and sharing compelling success stories that highlight the profound impact and fulfillment of serving in public health.

The Supporting Affordability and Fairness with Every Bet (SAFE) Act is a proposed federal legislation aimed at establishing minimum standards for sports betting across the United States. The SAFE Bet Act aims to help ensure minimum standards at in place throughout the United States for responsible gambling, protection of consumers, and maintaining the integrity of sports betting.

In today's globalized economy, businesses face an ever-changing landscape of tariffs, trade policies, and international supply chain challenges. For companies navigating these complexities, foreign trade zones (FTZs) present a strategic opportunity to reduce costs, improve logistical efficiency, and enhance overall competitiveness. 

As hospitals strive to balance their budgets and sustain primary care, there are options for hospitals to take that could ease financial burdens while preserving provider presence in the communities they serve. This article explores actionable models and strategies to reimagine primary care delivery in a way that benefits both patients and hospital systems.

In today's rapidly evolving business landscape, boards of directors are more than just stewards of governance—they are the strategic compass guiding an organization toward enduring success. As the challenges facing companies grow increasingly complex, from disruptive technological trends to shifting societal expectations, the board's role has never been more critical. 

Nonprofit audit committees play a pivotal role in maintaining transparency and accountability. Their responsibilities include financial oversight, compliance, reporting guidelines, risk management, external audits, internal audits, and ethical standards. Have you ever wondered what kinds of questions the audit committee should be asking of management and each other? Consider the following list of sample questions as a starting place.

How often does a new category of lending open up for the banking industry? This could happen if Congress ends federal tax exemptions for interest earned on municipal (“muni”) bonds. While a final decision has not yet been made, Congress is debating this option as they decide how to handle expiring provisions of the 2017 Tax Cuts and Jobs Act.

Employee retention is crucial in construction, where turnover can delay projects, increase training costs, and reduce efficiency. Statistics show that turnover in construction is approximately 21.4%, and with the industry facing an estimated labor shortage of 430,000 workers as of 2023, retaining skilled workers is vital. Here, we’ll look at proven strategies, backed by industry data and case studies, that small to medium-sized construction companies can use to reduce turnover and improve employee satisfaction.

As new regulations take shape and tariff frameworks continue to change, importers must assess their compliance strategies with heightened scrutiny. One of the most critical components of this evaluation is transfer pricing. 

Digital accessibility is more than a legal requirement—it’s about ensuring everyone can access public services, regardless of ability. As government agencies increasingly move services online, compliance with accessibility standards like the ADA’s Web Content Accessibility Guidelines (WCAG), EAA regulations, and Section 508 is essential. 

How does your nursing facility’s financial health stack up against industry peers? Benchmarking can provide you with the clear, relevant comparisons that are essential to measuring and optimizing your facility’s performance.

A financial institution’s core banking system, or core processing system, is an essential software that provides the backbone for day-to-day operations and transaction processing. Accounting for the costs of these systems can be tricky because of the complexities often involved in these contracts.

Last month, in honor of Women's History Month, we had the opportunity to speak with two women making waves in the parks and recreation industry—BerryDunn’s Becky Dunlap and Lakita Frazier. Both have built meaningful careers driven by a passion for community impact and the outdoors, forging paths that inspire others in the field. 

The construction industry presents some unique accounting and financial reporting requirements when it comes to construction work-in-progress (WIP) schedules. To keep a solid pulse on contract financial status and results, it is important that these schedules are accurate and up to date.

The FDIC's Quarterly Banking Profile for Q4 2024 reports positive performance for the 4,046 community banks evaluated.

On March 28, 2025, the FDIC issued a Financial Institution Letter (FIL), which rescinds its prior notification requirement for financial institutions engaging in crypto-related activities, as established in FIL-16-2022. 

In late 2024, the Centers for Medicare and Medicaid Services (CMS) launched a sweeping off-cycle mandate requiring all skilled nursing facilities (SNFs) in the United States to revalidate their Medicare provider enrollment record. Facilities of all types–including for-profit and not-for-profit–are affected.

To address evolving threats and regulatory challenges, OCR has issued proposed modifications to the Security Rule, introducing stricter security controls, mandatory encryption requirements, and a shift away from “addressable” implementation specifications. While these changes aim to improve data security, they also introduce new compliance burdens that could be challenging for many regulated entities. 

For foster teens, the path to adulthood is uniquely challenging. As thousands of young adults age out of the foster care system each year, many child welfare agencies are searching for ways to better support them through this transition. According to Dr. Elizabeth Wynter, child welfare advocate and author of Follow the Love: Permanent Connections Scaffolding, the key is to build strong youth-adult partnerships. In a recent episode of BerryDunn’s Fresh Perspectives in Social Work podcast, Dr. Wynter and I discussed the need for a “connection scaffold” and offered insights on improving outcomes for foster youth. Here are five take-aways from our conversation.

In today's data-driven world, the ability to share information between Medicaid and Public Health Agencies (PHAs) is crucial for efficiently using limited resources to serve both individual patient and population health goals and priorities. Often, states already have the needed technology, but they don’t have the partnerships or workforce infrastructure to leverage existing investments across different agencies.

Most nonprofits rely on federal and state government funds to fulfill their missions. With a federal funding freeze in the headlines, many clients are asking us how they can best prepare for a freeze and protect their organizations if funding is cut. Here are three steps you can take today to stay ahead. 

Public health is at a crossroads. With the lessons learned from COVID-19 and a workforce on the brink of burnout, now is the time for transformative action. By reimagining operations, infrastructure, and health equity, we can shape a system that’s responsive to future challenges.

If your organization is in the process of a large-scale project, such as replacing or implementing an electronic health record (EHR) system in the near future, success will depend on having a sound communication plan in effect before, during, and after the implementation. Fortunately, effective communication is not a difficult task to achieve. Based on our experience helping local governments implement EHR other systems nationwide, our team has developed five simple communication steps for successful implementations. 

The end of 4Q 2024 marks the start of a new year. In the Valuation Group, the end of the calendar year brings us to one of our busiest times of year: “ESOP season.” During the first few months of the year, we perform annual valuations for 30+ ESOP clients.

For manufacturers in New England, the global trade environment has always played a significant role in shaping supply chain strategies and cost structures. With the current tariff landscape marked by rapid changes and adjustments due to ongoing trade negotiations and economic strategies, businesses must be ready to quickly reevaluate their pricing models and material cost standards to maintain profitability. 

As the new year begins, your organization may be starting to plan for your next fundraising event. In addition to raising money for the organization, fundraising events are a wonderful way to build relationships within the community, raise awareness for a cause, and provide a meaningful experience to donors. Beyond the excitement and benefits of these events, there are important Form 990 reporting and compliance requirements that you must consider. Below are the most frequently asked questions we receive from our clients. We hope this helps you avoid some common pitfalls around fundraising events.

Rapid advancements in artificial intelligence (AI), robotics, quantum computing, and augmented reality will redefine how society functions by 2035

The market approach is one of three different ways to estimate the value of a company. In its simplest form, the market approach is fairly straightforward. Below is a very basic model for how a valuation could be applied:

Like many male-dominated industries, construction workplaces are often aligned with traditional masculine values such as self-reliance and stoicism, which can encourage resistance to traditional well-being approaches. 

The Financial Accounting Standards Board (FASB) has recently issued two significant Accounting Standards Updates (ASUs): ASU No. 2023-07 and ASU No. 2024-03. These updates aim to enhance the transparency and usefulness of financial disclosures for public business entities (PBEs) and are only applicable to PBEs.

Is your nonprofit using a break-even bottom line as your ultimate budget goal? If so, you may be missing out on opportunities to strategically further your mission. By looking at your budget using a statement of financial position perspective, rather than just a profit and loss perspective, you can gain a more complete financial picture of your organization.

As organizations navigate the complexities ahead in 2025, economic uncertainty presents both challenges and opportunities. Organizations must strategically address financial stability, donor engagement, federal compliance requirements, and workforce management to sustain their missions. This article dives into five critical finance trends and explores how nonprofits can effectively adapt.

The housing industry is subject to ongoing regulatory changes that are critical to their operations. Recently, we shared changes impacting compliance for multifamily housing, but that's just one example; all facets of the industry are subject to ongoing changes to compliance.

The FDIC's Quarterly Banking Profile for Q3 2024 reports positive performance for the 4,082 community banks evaluated.

Effective January 1, 2025, qualifying businesses in all Maine jurisdictions will be eligible for a generous, refundable credit while simultaneously investing in their business.

What Medicaid agencies and Medicaid-participating managed care organizations need to know about best practices for adhering to federal Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Requirements.

The Centers for Medicare & Medicaid Services (CMS) issued the final rule for the PPS for SNFs for FY 2025 which was published in the Federal Register on August 6, 2024, the regulations in this rule are effective October 1, 2024.

On November 6, 2024, members of the BerryDunn financial services team joined bankers and board members throughout the state of Maine at the annual Maine Bankers Association FDIC Directors’ College in Augusta, Maine. Here are our key takeaways from the event:

The election created a sense of anxiety and uncertainty among many people for a variety of reasons. One such concern was around how the election would affect business value.

The revenue cycle is an intricate system involving interdependent functions. Like an ecosystem, each component plays an important role. To optimize your revenue cycle, it helps to understand these four components of the ecosystem and the roles they play.

In this guide, we’ll explore the key benefits of the REAP Grant, explain who should consider applying, and highlight the important tax implications to help you make informed decisions about whether this program is right for your business.

This article explores the current trends in banking fraud, highlighting traditional schemes, emerging threats, and effective preventive measures.

These 7 success factors address the essential aspects of an economic development strategy––a roadmap for your community to encourage economic growth, create jobs, and improve the quality of life.

On July 25, 2024, the Public Company Accounting Oversight Board (PCAOB) issued its 2023 Annual Report on the Interim Inspection Program Related to Audits of Brokers and Dealers. The PCAOB can essentially be considered “the auditor of the auditor” and thus performs various inspections of audit firms that conduct broker-dealer audits on an annual basis.

The COVID-19 pandemic taught our public health systems a number of critical lessons about how we should engage, communicate, partner, and share data with other agencies and our communities. It also reinforced the importance of applying an intentional health equity lens to the system to better support vulnerable communities in times of crisis.  

The implementation of Financial Accounting Standards Board (FASB) Accounting Standards Codification (ASC) 606, Revenue from Contracts with Customers, which has been in effect since 2018 for broker-dealers, has had a profound impact on financial reporting across various industries. For broker-dealers, the adoption of this standard has introduced new challenges and considerations in recognizing revenue accurately and in accordance with the principles outlined in ASC 606.  

Your parks and recreation master plan was created with the goals and values of your community at its core. It’s part of what makes your community a great place to live, work, and play. It’s also a living document, designed to meet both current and future community needs—and to evolve as those needs change.

We often see broker-dealers receive 12b-1 fees in the course of ordinary business. With these fees, we often see the broker-dealer acting as a pass-through, retaining these fees on its balance sheet until the ultimate payee requests such funds, typically for payment or reimbursement of expenses that are permissible to be paid from 12b-1 fees, as outlined in the distribution agreement. These fees can often be substantial and result in significant receivables on the broker-dealer’s balance sheet.

Enterprise Resource Planning (ERP) systems provide a shared platform for people in your organization to work together––and the benefits can be game-changing. 

The SECURE Acts made several changes to 401(k) and 403(b) plan requirements. Among those changes is a change to the permissible minimum service requirements.

One of the key strategies to making the patient check-in process a good experience for patients, while also gathering the most important information for billing, is to have clear scripts for your patient access staff. 

The BerryDunn Parks, Recreation, and Libraries team is thrilled to share our highlights from the 2024 NRPA Annual Conference in Atlanta, which showcased the vibrant future of parks and recreation through exciting sessions, meaningful connections, and moments of celebration.

In April 2024, the Governmental Accounting Standards Board (GASB) issued GASB Statement No. 103, Financial Reporting Model Improvements.

A more popular addition to Medicaid Enterprise System Conference (MESC) discussions this year was AI, and attendees expressed both fear and excitement over its potential to tactically support the enterprise.

If it’s been a while since your nonprofit organization last conducted a review of its governing documents and policies, worry not, you’re not alone! This article will highlight a few of the most critical documents applicable to nonprofits to ensure you remain in compliance and good standing.

How should a business owner, management team, or investor estimate the value of its company? There are a variety of methods available in the world of business valuation. Let’s discuss the pros and cons of using a common financial metric in the assessment of a business’s value: Earnings Before Interest, Taxes, Depreciation, and Amortization (EBITDA).

If there’s one thing that was clear at the recent Medicaid Enterprise Systems Conference (MESC) in Louisville, it is that CMS is focused on meaningful enterprise planning, meaningful outcome definitions, and meaningful data from State Medicaid Agencies (SMAs) to illustrate trends throughout every phase of the IT life cycle and the benefit to Medicaid beneficiaries.

Although summertime is a generally slower time for the valuation team, we’ve seen a notable increase in M&A activity. Transactional activity often follows interest rate trends. We’ve seen activity pick up significantly in the last nine months under the current stable interest rate environment. As rates drop, more deals are sure to follow.

Nursing facilities need to be aware of a wide range of potential data uses for payer-based reporting (PBR) data and have comprehensive internal data review procedures to help ensure the public use file reflects accurate reporting and facility is prepared for an audit.   

For larger educational institutions that can receive hundreds of such disclosable donations in a given year, the Schedule B reporting onus can become downright brutal. However, there is a special rule available for Schedule B reporting that could greatly reduce that requirement. Fundraising and Development departments rejoice!

To help public health state agencies target budget and fiscal management training needs for their workforce, a comprehensive assessment can be utilized to examine four domains of administrative management activities with a focus on financial management.

At first glance, the healthcare patient check-in process seems straightforward. But when examined through the lens of your revenue cycle and patient experience, it’s one of the most important interactions for your team to get right.

Non-profit financial statements include a wealth of important knowledge but can often be overwhelming. When sharing your financial statements with your board of directors or other stakeholders, it can be useful to simplify your statements so the key information stands out and unimportant information doesn’t cause confusion.

Parks and recreation agencies, like any public-serving organization, have an obligation to equally serve all members of their communities. But knowing that something must be done is not the same thing as knowing how to approach it. As heard in a recent episode of the “Let’s Talk Parks with BerryDunn” podcast, host Becky Dunlap spoke with Meredith Tekin, President of the International Board of Credentialing and Continuing Education Standards (IBCCES), and Lane Gram, Manager for Parks and Recreation in Gilbert, Arizona, about how the town is undertaking the endeavor of making their parks and facilities accessible and enjoyable for all.

In February 2024, the American Association of State Highway and Transportation Officials (AASHTO) released a 2024 Edition of the Uniform Audit & Accounting (A&A) Guide, which supersedes the 2016 edition. The guide is a tool for architectural and engineering (A/E) firms calculating and reporting overhead rates to state transportation departments (DOTs), and to guide state DOT auditors and public accounting firms in performing audits of A/E firms’ indirect cost schedules.  

The United States Department of Housing and Urban Development (HUD) signed the Housing Opportunity through Modernization Act (HOTMA) into law on July 29, 2016. For multifamily housing owners, HOTMA went into effect on January 1, 2024, and owners are expected to be fully compliant by January 1, 2025.

To stay competitive in the recruitment and retention of employees, employers need to stay abreast of the current well-being trends—the ones that have the potential to move the needle in creating a thriving, healthy workforce.

The Centers for Medicare and Medicaid Services (CMS) has temporarily paused the Program for Comparative Billing Reports (CBRs) and Evaluating Payment Patterns Electronic Report (PEPPERs). During this pause, which is expected to end in the fall of 2024, CMS will be improving and updating the program.

In November 2023, the US Department of Labor’s Employee Benefits Security Administration (EBSA) issued its fourth assessment of the quality of audit work performed by independent qualified public accountants. Here are our five key takeaways.

Did you receive an Employee Retention Credit (ERC) that you now believe you were ineligible for? Since the ERC was announced, many ineligible claims have been filed, due to a variety of reasons, including companies working with ERC vendors that either did not understand the complexities or were not providing the due diligence necessary to ensure that the applications were complete and accurate.

Early-stage startups must often contemplate the most practical way to raise capital for their business. If traditional debt and equity methods are not available, different avenues to raising capital must be considered. Here are four alternatives to traditional debt and equity transactions:

The Corporate Transparency Act (CTA) was enacted into law by Congress on January 1, 2021, as part of the National Defense Authorization Act. The CTA mandates that every foreign or domestic entity registered to do business in the United States disclose Beneficial Ownership Information (BOI) beginning in 2024.

On December 20, 2023, the National Credit Union Administration (NCUA) issued a technical correction with the calculation of the Current Expected Credit Loss (CECL) transition amount.

A SOC report can be an invaluable tool in helping you gain confidence about your service providers.

With the rapid growth of Medicare Advantage (MA) plans in the last several years, many hospitals are struggling to effectively manage the financial and operational challenges of these plans, including:

• Increased denials of Medicare Advantage claims
• Confusion between Medicare, supplemental Medicare plans, and Medicare Advantage (Part C) plans, and what each cover
• Extra burden of “shadow billing” inpatient claims and leaving potential reimbursement off the table if not done correctly
• Compliance risk, including the risk of Medicare fraud

Derivatives can be used to hedge against a company’s exposure to a particular risk, whether that be the purchase price of materials or equipment, the selling price of a product a company has already purchased the materials to produce, or a variable rate of interest on debt.   

Staff turnover can present a number of challenges for independent schools. When staff turnover in your business office occurs, there are serious matters related to financial risk that you should consider.  

Owners of rental property who receive assistance from the US Department of Housing and Urban Development (HUD) through debt financing or tenant rent subsidies for affordable housing are subject to specific reporting and compliance requirements. It’s important to know and understand these requirements in order to be ready for audits, maintain compliance, and continue to receive funding. Here are three of the most complex requirements that anyone receiving funding from HUD needs to be aware of and have a process in place to help ensure compliance.  

In the realm of gaming and sports betting, maintaining proper security, privacy, and operational integrity are crucial in providing assurance to all parties involved. In such a heavily regulated industry, it is essential that sportsbook providers have the resources and professional advice needed for obtaining and maintaining compliance.

As we put a bow on another Medicaid Enterprise Systems Conference (MESC), I want to express my thanks to the New England States Consortium Systems Organization (NESCSO), the State of Colorado, and the City of Denver for hosting a fantastic event.

We’ve all heard stories about organizations spending thousands on software projects that take longer than expected to implement and exceed original budgets. One of the reasons this occurs is that organizations often don’t realize that purchasing a large, commercial off-the-shelf (COTS) system is a significant undertaking.