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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.

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. 

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. 

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.

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.

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. 

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.

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

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.

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.

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.

The Centers for Medicare and Medicaid Services (CMS) issued the Final Rule for the PPS for SNFs for FY 2024, which was published in the Federal Register on August 7, 2023. The regulations in this rule are effective October 1, 2023, except certain amendments, which are effective January 1, 2024. 

There’s a good chance that your organization is being forced to do more with less under the strain of budget constraints and competing initiatives. It’s a matter of survival. 

Executive compensation, bonuses, and other cost structure items, such as rent, are often contentious issues in business valuations, as business valuations are often valued by reference to the income they produce. If the business being valued pays its employees an above-market rate, for example, its income will be depressed. Accordingly, if no adjustments are made, the value of the business will also be diminished.

Across all industries, organizations are struggling to attract and retain the employees needed to provide services to their communities. From local governments to retail outlets to…well, just about everyone.

In the latest episode of the Let’s Talk Parks with BerryDunn podcast, we discussed the topic of retaining all-star employees as it relates to Parks and Recreation Departments who are struggling to maintain community services due to staffing levels. The conversation with my colleagues Nikki Ginger and Barbara Heller and our guests Nicole Falceto and Fernando Avellanet from the Loudoun County (Virginia) Parks, Recreation and Community Services Department uncovered tangible and actionable strategies that any type of organization can use to start the process of improving their organizational culture to better retain staff.

Organizational change is hard. And necessary. And manageable.

You know your organization needs to change – to develop a better culture, to enhance efficiencies, or to improve outcomes. But where do you start?

In our most recent episodes of the Fresh Perspectives in Social Work Podcast, I had a conversation about this subject with organizational development experts Megan Clough, Manager with the State Government Practice Group at BerryDunn, and Jennifer Kerr, Director of Organizational Effectiveness at American Public Human Services Association (APHSA).

At BerryDunn, our healthcare consulting teams have worked with hundreds of organizations as they’ve transitioned to new enterprise systems such as Electronic Health Records (EHR) systems and Enterprise Resource Planning (ERP) systems. Based on our experience, there are 10 key areas to focus on in order to have a successful conversion.   

It can be challenging and stressful to plan for technology initiatives, especially those that involve and impact every area of your organization. 

Do you have a CEO succession plan? If not, you need to create one now.

This article is the first in a series to help employee benefit plan fiduciaries better understand their responsibilities and manage the risks of non-compliance with ERISA requirements.

Follow these six steps to help your senior living organization improve cash flow, decrease days in accounts receivable, and reduce write offs. 

As we find ourselves in a fast-moving, strong business growth environment, there is no better time to consider the controls needed to enhance your IT security as you implement new, high-demand technology and software to allow your organization to thrive and grow. Here are five risks you need to take care of if you want to build or maintain strong IT security.

In light of the recent cyberattacks in higher education across the US, more and more institutions are finding themselves no longer immune to these activities. Security by obscurity is no longer an effective approach—all institutions are potential targets. Colleges and universities must take action to ensure processes and documentation are in place to prepare for and respond appropriately to a potential cybersecurity incident.

This is the second blog post in the blog series: “Procuring Agile vs. Non-Agile Service”. Read the first blog. This blog post demonstrates the differences in Stage 1: Plan Project in the five stages of procuring agile vs. non-agile services.

Measuring performance of Medicaid Enterprise Systems (MES) is emerging as the next logical step in modularizing Medicaid programs. As CMS continues to refine and implement outcomes-based modular certification, it is critical that states adapt to this next step in order to continue to meet CMS funding requirements.

On June 18, 2019, the State of Maine enacted Legislative Document 1819, House Paper 1296, An Act to Harmonize State Income Tax Law and the Centralized Partnership Audit Rules of the Federal Internal Revenue Code of 1986

Planning and development service fees are, for many municipalities, often discussed but rarely changed. There are a number of reasons you might need to consider or defend your fee structure―complaints from developers, rising costs of operation, and changes in code or process are just a few.

Patient Driven Payment Model (PDPM) implementation is less than three months away. Is your facility ready for admissions under PDPM? The way you think about admissions and the admission process will change under PDPM.

In my last blog, I defined the what and the why of data governance, and outlined the value of data governance in higher education environments. I also asserted data isn’t the problem―the real culprit is our handling of the data (or rather, our deferral of data responsibility to others).

Proposed House bill brings state income tax standards to the digital age

On June 3, 2019, the US House of Representatives introduced H.R. 3063, also known as the Business Activity Tax Simplification Act of 2019, which seeks to modernize tax laws for the sale of personal property, and clarify physical presence standards for state income tax nexus as it applies to services and intangible goods. But before we can catch up on today, we need to go back in time—great Scott!

As the Project Management Body of Knowledge® (PMBOK®) explains, organizations fall along a structure and reporting spectrum. On one end of this spectrum are functional organizations, in which people report to their functional managers. (For example, Finance staff report to a Finance director.) On the other end of this spectrum are projectized organizations, in which people report to a project manager. Toward the middle of the spectrum lie hybrid—or matrix—organizations, in which reporting lines are fairly complex; e.g., people may report to both functional managers and project managers. 

As your organization works to modernize and improve your Medicaid Enterprise System (MES), are you using independent verification and validation (IV&V) to your advantage? Does your relationship with your IV&V provider help you identify high-risk project areas early, or provide you with an objective view of the progress and quality of your MES modernization initiative? Maybe your experience hasn’t shown you the benefits of IV&V. 

The IRS announced plans to conduct examinations of the universal availability requirements for 403(b) plans (Plans) this summer. Noncompliance with these requirements results in operational errors for Plans―ultimately requiring correction. Plan sponsors should review their Plans for proper inclusion and exclusion of employees. Such review can help you avoid costly penalties if the IRS does conduct an examination and uncovers an issue with the Plan’s implementation of universal availability.

Best practices for financial institution contracts with technology providers

As the financial services sector moves in an increasingly digital direction, you cannot overstate the need for robust and relevant information security programs. Financial institutions place more reliance than ever on third-party technology vendors to support core aspects of their business, and in turn place more reliance on those vendors to meet the industry’s high standards for information security. These include those in the Gramm-Leach-Bliley Act, Sarbanes Oxley 404, and regulations established by the Federal Financial Institutions Examination Council (FFIEC).

What is the difference in how government organizations procure agile vs. non-agile information technology (IT) services?

Focus on the people: How higher ed institutions can successfully make an ERP system change

The enterprise resource planning (ERP) system is the heart of an institution’s business, maintaining all aspects of day-to-day operations, from student registration to staff payroll. Many institutions have used the same ERP systems for decades and face challenges to meet the changing demands of staff and students. As new ERP vendors enter the marketplace with new features and functionality, institutions are considering a change. Some things to consider.

LIBOR is leaving—is your financial institution ready to make the most of it?

In July 2017, the UK’s Financial Conduct Authority announced the phasing out of the London Interbank Offered Rate, commonly known as LIBOR, by the end of 20211. With less than two years to go, US federal regulators are urging financial institutions to start assessing their LIBOR exposure and planning their transition. Here we offer some general impacts of the phasing out, specific actions your institution can take to prepare, and, finally, some background on how we got here (see Background at right).

Who has the time or resources to keep tabs on everything that everyone in an organization does? No one. Therefore, you naturally need to trust (at least on a certain level) the actions and motives of various personnel. At the top of your “trust level” are privileged users—such as system and network administrators and developers—who keep vital systems, applications, and hardware up and running.

Law enforcement, courts, prosecutors, and corrections personnel provide many complex, seemingly limitless services. Seemingly is the key word here, for in reality these personnel provide a set number of incredibly important services.

“The world is one big data problem,” says MIT scientist and visionary Andrew McAfee.

That’s a daunting (though hardly surprising) quote for many in data-rich sectors, including higher education. Yet blaming data is like blaming air for a malfunctioning wind turbine. Data is a valuable asset that can make your institution move.

Best Practices for Educating Your Financial Institution’s Board of Directors on Cybersecurity

According to Cybersecurity Ventures, cybercrime will account for $6 trillion annually by 2021—that’s more than the global trade of all major illegal drugs combined.  Data breaches and other information security events adversely impact organizations through significant losses in revenue, erosion of customer trust, substantial remediation costs, increased insurance premiums, and more.

Not-for-profit board members need to wear many hats for the organization they serve. Every board member begins their term with a different set of skills, often chosen specifically for those unique abilities. As board members, we often assist the organization in raising money and as such, it is important for all members of the board to be fluent in the language of fundraising. Here are some basic definitions you need to know, and the differences between them

Writing a Request for Proposal (RFP) for a new software system can be complex, time-consuming, and—let’s face it—frustrating, especially if you don’t often write RFPs. The process seems dogged by endless questions, such as:

On October 1, 2019, the Medicare Skilled Nursing Facility (SNF) payment system will transition from RUGS-IV to the Patient Driven Payment Model. This payment model is a major change from the way SNFs are currently reimbursed.

Of all the changes that came with the sweeping Tax Cuts and Jobs Act (TCJA) in late 2017, none has prompted as big a response from our clients as the changes TCJA makes to the qualified parking deduction.

In auditing, the concept of professional skepticism is ubiquitous. Just as a Jedi in Star Wars is constantly trying to hone his understanding of the “force”, an auditor is constantly crafting his or her ability to apply professional skepticism. 

As a new year is upon us, many people think about “out with the old and in with the new”. For those of us who think about technology, and in particular, blockchain technology, the new year brings with it the realization that blockchain is here to stay (at least in some form).

A capital campaign is a big undertaking. During the planning stage of a capital campaign you need to not only focus on your donor outreach strategy, but also on outreach materials. 

The existing case mix classification group, Resource Utilization Group IV (RUG- IV) will be replaced with a new case mix model, the Patient Driven Payment Model (PDPM). CMS has indicated factors leading to the change in the payment system include over utilization of therapy and incentives for longer lengths of stay.

Good fundraising and good accounting do not always seamlessly align. While they all feed the same mission, fundraisers work to meet revenue goals while accountants focus on recording transactions in compliance with accounting standards. 

Your government agency just signed the contract to purchase and implement a shiny new commercial off-the-shelf (COTS) software to replace your aging legacy software. The project plan and schedule are set; the vendor is ready to begin configuration and customization tasks; and your team is eager to start the implementation process.

A common pitfall for inbound sellers is applying the same concepts used to adopt “no tax” positions made for federal income tax purposes to determinations concerning sales and use tax compliance. Although similar conceptually, separate analyses are required for each determination.

All teams experience losing streaks, and all franchise dynasties lose some luster. Nevertheless, the game must go on. 

This October, my colleagues and I attended the National Association of Health Data Organizations (NAHDO) annual meeting in Park City, Utah. NAHDO is a national non-profit membership and educational association dedicated to improving healthcare data collection and use.

As 2018 is about to come to a close, organizations with fiscal year ends after December 15, 2018, are poised to start implementing the new not-for-profit reporting standard. Here are three areas to address before the close of the fiscal year to set your organization up for a smooth and successful transition, and keep in compliance:

It’s that time of year. Kids have gone back to school, the leaves are changing color, the air is getting crisp and… year-end tax planning strategies are front of mind! 

Reading through the 133-page exposure draft for the Proposed Statement on Auditing Standards (SAS) Forming an Opinion and Reporting on Financial Statements of Employee Benefit Plans Subject to ERISA, issued back in April 2017, and then comparing it to the final 100+ page standard approved in September 2018, may not sound like a fun way to spend a Sunday morning sipping a coffee (or three), but I disagree.

I leaned out of my expansive corner office (think: cubicle) and asked my coworker Andrew about an interesting topic I had been thinking about. “Hey Andrew, do you know what BATNA stands for?” I asked. 

State governments regularly negotiate contracts with vendors. Unfortunately, these negotiations are often prolonged, which can have major downstream effects on projects, procurements, and implementations—including skewed timelines, delayed milestones, and increased costs. 

With the wind down of the Federal Perkins Loan Program and announcement that the Federal Capital Contribution (FCC) (the federal funds contributed to the loan program over time) will begin to be repaid, higher education institutions must now decide how to handle these outstanding loans.

Reflecting on this year's National Academy for State Health Policy (NASHP) Conference in Jacksonville, Florida, I am amazed by all the recent healthcare innovations, which are resulting in policies with real and positive effects on health outcomes.

Modernization means different things to different people—especially in the context of state government. For some, it is the cause of a messy chain reaction that ends (at best) in frustration and inefficiency. For others, it is the beneficial effect of a thoughtful and well-planned series of steps. 

Truly effective preventive health interventions require starting early, as evidenced by the large body of research and the growing federal focus on the role of Medicaid in addressing Social Determinants of Health (SDoH) and Adverse Childhood Experiences (ACEs).

Do you want to receive top dollar for your business? Do you want to make your business irresistible to a potential buyer? Looking for a stress-free retirement? If you find yourself answering “yes” to these questions, it’s time to take steps to create a transferable business.

Last week, in addition to The Eagles Greatest Hits (1971-1975) album becoming the highest selling album of all time, overtaking Michael Jackson’s Thriller, the IRS issued Notice 2018-67—its first formal guidance on Internal Revenue Code Section 512(a)(6).

Artificial Intelligence, or AI, is no longer the exclusive tool of well-funded government entities and defense contractors, let alone a plot device in science fiction film and literature. Instead, AI is becoming as ubiquitous as the personal computer. 

The world of professional sports is rife with instability and insecurity. Star athletes leave or become injured; coaching staff make bad calls or public statements. The ultimate strength of a sports team is its ability to rebound. The same holds true for other groups and businesses.

As I head home from a fabulous week at the 2018 Medicaid Enterprise Systems Conference (MESC), I am reflecting on my biggest takeaways. Do we have the information we need to effectively move into the next 12 months of work in the Medicaid space? My initial reaction is YES!

Here we go again! With the 2018 Medicaid Enterprise System Conference (MESC) underway, we have another Medicaid Enterprise Certification Toolkit (MECT) Release. On July 31, 2018, the Centers for Medicare and Medicaid Services (CMS) issued the MECT Version 2.3.

Although there is no legal requirement to have a formal shareholder agreement, it’s a good idea for any company with more than one shareholder to have one, as it reduces the potential for conflict between shareholders, helping the company run smoothly and profitably. 

Is your state Medicaid agency considering a Centers for Medicare and Medicaid Services (CMS) Section 1115 Waiver to fight the opioid epidemic in your state? States want the waiver because it provides flexibility to test different approaches to finance and deliver Medicaid services.

All business owners need to consider a business valuation, ideally updated annually. A current business valuation is important for your company’s financial health as it can:

Are you struggling to improve business outcomes through modifications to your software solutions? If so, then you have no doubt tried — or are trying — traditional software implementation approaches. Yet, these methods can overwhelm staff, require strong project management, and consume countless hours (and dollars).

By now, you know all about the new corporate tax rate — a flat rate of 21% vs. the previous top tax rate of 35% — arguably the most publicized change of the recently passed Tax Cuts and Jobs Act (TCJA).

Any sports team can pull off a random great play. Only the best sports teams, though, can pull off great plays consistently — and over time. The secret to this lies in the ability of the coaching staff to manage the team on a day-to-day basis, while also continually selling their vision to the team’s ownership.

For over four years the business community has been discussing the impact Accounting Standards Codification (ASC) 606, Revenue from Contracts with Customers, will have on financial reporting. As you evaluate the impact this standard will have on a manufacturers’ financial reporting practices, there are certain provisions of ASC 606 you should consider.

The late science fiction writer (and college professor) Isaac Asimov once said: “I do not fear computers. I fear the lack of them.” Had Asimov worked in higher ed IT management, he might have added: “but above all else, I fear the lack of computer staff.”

When an organization wants to select and implement a new software solution, the following process typically occurs:

People are naturally resistant to change. Employees facing organizational change that will impact day-to-day operations are no exception, and they can feel threatened or fearful of what that change will bring. Even more challenging are multiyear initiatives where the project’s completion is years away.

Cost increases and labor issues have contributed to the rise of outsourcing as an option for senior living and health care providers.  While outsourcing of all types is a growing trend — from the C-suite to food service, it is a decision that should be considered carefully, as lack of planning could result in significant long-lasting financial, public relations and personnel losses. 

The day-to-day work of providing government services involves collecting, using, and storing large amounts of data. The data that government agencies accumulate is a critical asset — it holds answers about which programs perform best, which interventions are most effective, and how to improve service delivery. 

A professional sports team is an ever-changing entity. To have a general perspective on the team’s fluctuating strengths and weaknesses, a good coach needs to trust and empower their staff to discover the details. Chapter 5 in BerryDunn’s Cybersecurity Playbook for Management looks at how discovery can help managers understand their organization’s ever-changing IT environment. 

While new software applications help you speed up processes and operations, deciding which ones will work best for your organization can quickly evolve into analysis paralysis, as there are so many considerations.

Over the course of its day-to-day operations, every organization acquires, stores, and transmits Protected Health Information (PHI), including names, email addresses, phone numbers, account numbers, and social security numbers.

With the rise of artificial intelligence, most malware programs are starting to think together. Fortinet recently released a report that highlights some terms we need to start paying attention to:

Just as sports teams need to bring in outside resources — a new starting pitcher, for example, or a free agent QB — in order to get better and win more games, most organizations need to bring in outside resources to win the cybersecurity game.

The first time a student walks into a business class, they may expect to learn a lot about numbers. What they might not realize is they are walking into a foreign language class! 

As a leader in a higher education institution, you'll be familiar with this paradox: Every solution can lead to more problems, and every answer can lead to more questions. It’s like navigating an endless maze. When it comes to mobile apps, the same holds true. 

The recent Tax Cuts and Jobs Act includes many sweeping tax law changes, some of which left taxpayers scrambling at the end of 2017 to maximize tax saving opportunities. While the dust settles on tax reform at the federal level, the whirlwind at the state level is just beginning, with many unanswered questions.

Large-scale projects require extensive planning, quick decision-making, thoughtful problem-solving, and above all else, resourcefulness. One way to be resourceful? 

It may be hard to believe some seasons, but every professional sports team currently has the necessary resources — talent, plays, and equipment — to win. The challenge is to identify and leverage them for maximum benefit.

Did you know that there was more than a 40% increase (from $4.3 billion to $6.0 billion) in civil penalties assessed by the IRS regarding employment tax, for the 2016 fiscal year?

Texting has become a simple, convenient, and entrenched component of our everyday lives. We use it with family, friends, coworkers—and clients. My wife and I text to coordinate day care pickup and drop off of our kids every day.

We know, both from our experience as external auditors (all of us) and years of experience working in private sector firms (many of us), that changing audit firms can be a painful process. NOTE: if you’re a current BerryDunn client, feel free to stop reading here.

It’s one thing for coaching staff to see the need for a new quarterback or pitcher. Selecting and onboarding this talent is a whole new ballgame. Various questions have to be answered before moving forward: 

Private-sector pundits love to drone on about drones! Also known as Unmanned Aircraft Systems (UASs), drones are dramatically altering processes and increasing opportunities in the for-profit world. 

Success is slippery and can be evasive, even on the simplest of projects. Grasping it grows harder during lengthier and more complex undertakings, such as enterprise-wide technology projects—and requires incorporating a variety of short- and long-term strategies. 

When it comes to IT security, more than one CEO running a small organization has told me they have really good people taking care of “all that.” These CEOs choose to believe their people perform good practices. 

A penalty letter doesn’t mean the IRS is correct, but it’s important you know what to do to avoid paying an erroneous penalty. 

Most of us have been (or should have been) instructed to avoid using clichés in our writing. These overstated phrases and expressions add little value, and often only increase sentence length. We should also avoid clichés in our thinking, for what we think can often influence how we act.

In a previous blog post, “Six Steps to Gain Speed on Collections”, we discussed the importance of regular reviews of long-term care facility financial performance indicators and benchmarks, and suggestions to speed up collections. 

Is your organization a service provider that hosts or supports sensitive customer data, (e.g., personal health information (PHI), personally identifiable information (PII))? 

The relationship between people, processes, and technology is as elemental as earth—and older than civilization. From the first sharpened rock to the Internet of Things, the three have been crucially intertwined and interdependent. 

For professional baseball players who get paid millions to swing a bat, going through a slump is daunting. The mere thought of a slump conjures up frustration, anxiety and humiliation, and in extreme cases, the possibility of job loss.

After working with state health policy for seven years and Medicaid for 16, I had the opportunity for the first time to attend the 30th Annual National Association of State Health Policy (NASHP) Conference on October 23–25, 2017. Here are my top three takeaways.

The Federal Perkins Loan Program expiration date has passed without extension and now the countdown is on for the program wind-down.

Of course, we’re all suffering from “data breach fatigue.” But some breach announcements carry considerably more risk to the victim than others. For example, if I had received a letter saying a credit card of mine had been compromised, the end result would be simple:

The Merriam-Webster Dictionary defines leadership as having the capacity to lead. Though modest in theory, the concept of leadership permeates all industries and is a building block for every organization’s success. 

As more state and local government workers enter retirement, state and local agencies are becoming more dependent on millennial workers — the largest and most educated generation of workers in American history. But there is a serious gap between supply and demand.

Have you ever had a project derail at the last minute, or discovered that a project’s return on investment did not meet projections? These types of issues happen in the final stages of a project, often as a result of incorrect or incomplete stakeholder identification.

The MESC “B’more for healthcare innovation” is now behind us. This annual Medicaid conference is a great marker of time, and we remember each by location: St. Louis, Des Moines, Denver, Charleston… and now, Baltimore. 

Here’s a challenge for you: Can you identify the number one predictor of project success? According to Prosci, the leading change-management research organization, the answer is the project sponsor.

A year ago, CMS released the Medicaid Enterprise Certification Toolkit (MECT) 2.1: a new Medicaid Management Information Systems (MMIS) Certification approach that aligns milestone reviews with the systems development life cycle (SDLC) to provide feedback at key points throughout design, development, and implementation (DDI).

Today’s senior living providers must ensure that their mission and vision for the future are built on a healthy financial plan and structure. Here are some things you should know to build just that.

While GASB has been talking about split-interest agreements for a long time (the proposal first released in June of 2015, with GASB Statement No. 81, Irrevocable Split-Interest Agreements released in March of 2016), time is quickly running out for a well-planned implementation.

Because we’ve been through this process many times, we’ve learned a few lessons and determined some best practices. Here are some tips to help you promote a positive post go-live experience.

Some days, social media seems nothing more than a blur of easily forgettable memes. Yet certain memes keep reappearing to the point where we have no choice but to remember them. 

Four steps to take if you get an ACA Tax Penalty Notice from the IRS. It’s been almost a year since the IRS filing deadline for 2015 Forms 1094-C and 1095-C. Most expected the IRS to issue employer penalty notices related to the 2015 calendar year in late 2016.

We have talked about the two recent GAAP updates for years now: 1) changes to the lease accounting and 2) changes to revenue recognition standards. 

We all know them. In fact, you might be one of them — people who worry the words “go live” will lead to job loss (theirs). This feeling is not entirely irrational. 

Recently the Governmental Accounting Standards Board (GASB) finished its Governmental Accounting Research System (GARS), a full codification of governmental accounting standards.

We humans have a complex attitude toward change. In one sense, we like finding it. For instance: “Now I can buy something from the vending machine!” In reality, we try to avoid change as much as possible. Why? 

RANSOMWARE UPDATE: It happened again. Another ransomware attack hit very large corporations around the globe. Much like WannaCry, a worm spread through entire networks, and locked out encryption data and systems.

On June 16th the FASB issued the final standard for credit losses. We’ve analyzed the new standard and pulled together some key items you’ll need to know:

As the technology we use for work and at home becomes increasingly intertwined, security issues that affect one also affect the other and we must address security risks at both levels.

In July 2016, we wrote about how the booming microbrewery scene in Maine is shaking up the three-tier system of alcohol distribution, which dates back to the 1930s.

As we begin the second year of Uniform Guidance, here’s what we’ve learned from year one, and some strategies you can use to approach various challenges, all told from a runner's point of view.

During my lunch in sunny Florida while traveling for business, enjoying a nice reprieve from another cold Maine winter, I checked my social media account.

When last we blogged about the Financial Accounting Standards Board’s (FASB) new “current expected credit losses” (CECL) model for estimating an allowance for loan and lease losses (ALLL), we reviewed the process for developing reasonable and supportable forecasts for use in establishing the ALLL. 

Government projects conducted in challenging conditions require trust, collaboration, communication, and project management acumen to succeed. Here are five recommendations for project success.

Recently, federal banking regulators released an interagency financial institution letter on CECL, in the form of a Q&A. Read it here

Retiring Baby Boomers and the competition for skilled workers of any age mean employers need to use new strategies to transfer institutional knowledge and maintain a thriving workforce.

NEW IRS proposed guidance is welcome news and provides not-for-profit employers with more flexibility than originally expected.

Electronic accessibility in every aspect of modern life has increased ten-fold, but government — and courts in particular — has been slow to follow.

When it comes to offering non-qualified deferred compensation to executives of not-for-profit organizations, there aren’t many options.

People love the idea of being able to conveniently charge their phones without a cable or having to hunt for a plug. Free charging stations are popping up everywhere.

By now, pretty much everyone in the banking industry has heard plenty of talk about CECL – the forthcoming “Current Expected Credit Loss” model of accounting for an institution’s allowance for loan losses (ALL).

Financial fraud by the numbers. In a June 2016 Gallup poll, 72 percent of respondents said they had “very little” or only “some” confidence in banks.

By now you have heard that the Financial Accounting Standards Board’s (FASB) answer to the criticism the incurred-loss model for accounting for the allowance for loan and lease losses faced during the financial crisis has been released in its final form. 

Many of my hospital clients have an increased incidence of providing temporary housing for locums, temps and some employees and, as a result, have questions regarding the proper tax reporting to these individuals.   

With the implementation of GASB 72 now in full force, GASB organizations are hard at work drafting their new fair value disclosures. The addition of a fair value hierarchy table in the footnotes will add a bit more thickness to a likely already hefty financial package. 

There is plenty of media coverage of Maine’s, and specifically Portland’s, burgeoning microbrew scene. It’s good economic development and complements the already established “foodie” scene Portland is renowned for.

Online banking? Check. Online shopping? You bet. Online permit application submittal? What? Actually, yes. As Americans are becoming more and more accustomed to performing everyday functions online, local governments are evolving and keeping up with the times. This online evolution is coming in the form of implementing modern enterprise applications with electronic workflow and a public-facing portal that allows residents to apply for permits, submit documentation, pay for, and collaborate with local government staff to perform a variety of processes.

Why it can happen to you and how to protect yourself. We’ve all seen the headlines. Stories about not-for-profit fraud have been popping up in the news, and the statistics confirm what you might have suspected: fraud in the not-for-profit sector is on the rise.

With the most recent overhaul to the Form 990, Return of Organization Exempt From Income Tax, the IRS has made clear its intention to increase the transparency of a not-for-profit organization’s mission and activities and to promote active governance. To point, the IRS asks whether a copy has been provided to an organization’s board prior to filing and requires organizations to describe the process, if any, its board undertakes to review the 990.

Read this if you are a CFO, COO, or a revenue cycle or finance professional at a healthcare organization. 

While uncertainties remain until this bill moves through the US Senate, now is the time for healthcare organizations to develop a strategic plan. This article offers guidance on potential impacts and how to prepare for them. 

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 effects of proposed Medicaid cuts 

A closer look at the impact proposed changes would have on healthcare organizations illustrates the interconnectedness of the system.  

  • Changes to eligibility requirements for Medicaid coverage will reduce the number of insured and result in patients delaying or skipping preventative care. 

  • Major commercial payers have traditionally subsidized Medicaid underpayments through higher reimbursement rates. The changes would increase pressure on carriers and hospitals to figure out how to do more with less. 

  • Proposed co-payments for services covered under Medicaid will increase the collection burden of healthcare providers. 

  • Uncompensated care will increase at hospitals and lead to overcrowded emergency departments, which EMTALA (Emergency Medical Treatment & Labor Act) stipulates must provide emergency care to anyone requesting it.  

  • Costs for care under EMTALA are absorbed through various federal, state, or local programs. These programs are disappearing, leaving hospitals financially vulnerable with no guaranteed reimbursement for services. 

  • Rural hospitals could be forced to end specialty services or close.  

  • Enhanced premium tax credits implemented during the COVID-19 pandemic are set to be rolled back and could cause millions to lose healthcare, exacerbating the crisis of uninsured Americans.  

  • Many medical practices already limit Medicaid patients due to low reimbursement. Cuts are likely to further lower participation and limit access to care. 

  • Community health centers could lose federal grants tied to Medicaid enrollment, which could lead to closure. 

  • Medicaid is the largest payer for long-term care facilities and nursing homes. Changes to retroactive eligibility (from three months to one month) and other funding cuts would lead to staffing shortages, lower quality of care, and facility closures.  

  • Increased scrutiny and regulatory changes on Medicaid could decrease already low reimbursement rates, causing some of the major commercial providers of managed Medicaid to pull out, further limiting access to healthcare and increasing pressure on already understaffed and underfinanced organizations.  

  • Medical providers and commercial payers would pass along increasing costs for procedures to employer groups and individuals, resulting in premium and cost-sharing increases.  

The proposed reductions confront healthcare organizations with difficult decisions about what they can and will continue to fund.  

Tariffs and the medical supply chain 

The administration’s proposed and current tariffs are also greatly impacting healthcare organizations through the supply chain. Organizations build supply costs at a set rate into their reimbursement arrangements with commercial payers projecting minor fluctuation. If the cost of necessary supplies increases, they are at a loss. Some examples of tariff-related supply chain reimbursement issues include: 

  • Everyday supplies like disposable medical gloves, which are widely used across the industry and of which 90% are manufactured overseas and are not billable. With the introduction of tariffs, the costs have skyrocketed.  

  • Implants and devices are also manufactured overseas—all of which have been hit with tariffs.  

  • Pharmaceuticals are manufactured all over the world. Even drugs manufactured in the US often include an active ingredient that is imported.   

The tariffs have created a ripple effect. Increased costs are absorbed by consumers, and in some cases have forced providers to reduce services or even shut their doors when combined with the rising cost of labor in the US and reimbursement changes. 

Funding freeze impacts  

An Executive Order (EO) earlier this year related to the cessation of payment grant support deeply affected healthcare organizations. Despite these federal funds being appropriated, the EO stopped payments, putting many programs and organizations in jeopardy.  

From healthcare facilities providing emergency care to the uninsured to community health centers reliant on 340b and grant funding to remain sustainable, and nonprofit entities providing social and behavioral services, hospitals, and more, the funding stoppage has impacted the industry. For some, it meant not making payroll, or ending programs or services, and for others it forced their closure, further restricting access to care in communities.  

Developing a plan 

Healthcare organizations need to be strategic to weather the current uncertainties. Find ways to position your organization by analyzing its financial situation and creating an innovative roadmap. 

  • Hospitals have been mentioned in the discussion surrounding nonprofit status. Consider what would change if you lost your tax-exempt status. Are there changes you could be making now that could mitigate potential implications of a change? 

  • Look at your payer mix. Are there ways to manage it to your advantage?  

  • When was the last time you negotiated your commercial payer contracts? Are there clauses in the contract that would allow other items to be billed or fluctuations in cost?  

  • For nonprofits, take a hard look at all sources of funding. Are there unrestricted funds, such as philanthropic gifts, that could be shifted, if necessary?  

  • How can you optimize your payment structure? Are you billing for the things you should be billing for? Are you collecting everything that you should be collecting? Confirm you aren’t leaving any reimbursement opportunities on the table. 

  • Examine your margin compression and identify where you might be able to find efficiencies. Find the waste and remove it.  

While the cost of delivering healthcare has steadily risen, Medicaid reimbursements have not adjusted proportionally. With the proposed Medicaid changes, healthcare organizations must strategically prepare by analyzing financial outcomes at every level. BerryDunn’s team of experts can help you optimize your revenue and find thoughtful solutions to minimize your risk, allowing you to remain operational. Learn more about our team and services

Article
Bracing for Medicaid cuts: What healthcare organizations need to know

The US Department of Health and Human Services Office of Inspector General (HHS-OIG) has been actively enforcing healthcare compliance and fraud prevention in 2025. Here’s what healthcare providers need to know.  

Recent enforcements 

In April, there were three enforcement actions taken against providers who have breached their integrity agreements. 

  1. April 3, 2025: $22,000 penalty 

  1. April 17, 2025: $74,000 penalty  

  1. April 18, 2025: $1,600 penalty 

Due to the cumbersome nature of corporate integrity documents, BerryDunn encourages its clients to revisit these documents often to help ensure important deadlines are met.  

Increased enforcement areas 

There has been a noticeable uptick in enforcement for two areas in particular—wound care and incident-to billing.  

Skin substitutes have also landed on the OIG work plan this year. 

Clients have been flagged by payers for issues with claims and disclosure of rebates and discounts. CMS has decided to delay finalizing the proposed LCD (Local Coverage Determination) for skin substitute grafts and cellular/tissue-based products used in the treatment of chronic non-healing wounds until January 2026. However, we don’t anticipate this will reduce the number of audits.  

Incident-to billing continues to be a hot topic and one of confusion for many clients. Organizations may want to consider having a third-party probe audit to help ensure appropriate coding and clinical documentation.  

BerryDunn’s healthcare compliance team incorporates deep, hands-on knowledge with industry best practices to help ensure your operation is compliant and efficient. Learn more about BerryDunn’s team and services. 

Article
Healthcare compliance enforcement: Are you ready?

Read this if you are a board member or c-suite executive of a community bank.

When it’s time to change auditors, it’s important to find a firm that feels like a long-term partner—one you can grow with over time. The key to finding that fit is asking the right questions up front. Before moving forward with a firm, make sure you’re comfortable with their answers to the following: 

  1. Does the firm have experience in your industry? 
    Look for an audit partner who understands the specific challenges and technical requirements of your industry. Experience in your sector ensures a more accurate and efficient audit while reducing the risk of audit failures, such as independence issues or incorrect implementation of new accounting standards. Audit failures can be costly and erode confidence with your board, investors, and regulators. 
     
  2. Has the firm worked with organizations similar to yours? 
    Familiarity with your size, structure, and operations allows the audit team to navigate the process more effectively, saving you time and effort. 
     
  3. Does the firm stay current with relevant financial reporting requirements? 
    With regulations constantly changing, your auditor should stay up-to-date and proactively inform you of any updates that might impact your organization. Reviewing a firm’s content and resources can give you an idea of how invested they are in keeping current. 
     
  4. Is the audit process efficient and minimally disruptive? 
    Choose a firm with systems and experience that allow them to conduct a thorough audit without placing unnecessary strain on your team. 
     
  5. Do you have year-round access to the audit team? 
    A good audit partner offers ongoing support and is available for consultation throughout the year, not just during the audit. In a world where change is constant, partnering with a firm that keeps you informed year-round is invaluable. 
     
  6. Does the firm offer additional specialized services? 
    As your organization grows, so will your needs. A firm that offers a broad range of services can support you well beyond just the audit. 
     
  7. Is the firm selective about its clients? 
    A reputable audit firm carefully chooses its clients, focusing on industries where they have proven expertise and can deliver true value. 
     
  8. What do their clients say about them? 
    This is all about culture. Does the firm "do the right thing" when it matters? Do they value integrity, curiosity, and relationships? A firm that treats its clients with respect and operates with integrity will provide lasting value. 

A great audit partner empowers you, educates you, and supports you through changes with confidence. They work hard to do things the right way—because when it comes to financial institutions, that’s the only way. 

Take the stress out of your next audit 
Audits don’t have to be stressful. When switching audit firms, the right support makes all the difference. Choosing a financial services provider is more than just a business decision—it’s a relationship that can significantly impact your financial future. Take your time, ask the tough questions, and prioritize trust, expertise, and alignment with your long-term goals.  

At BerryDunn, we’re here to make the process smoother, easier, and a lot less stressful. Our Financial Statement Audit team helps you stay prepared, minimize disruption, and feel confident that you’re doing the right thing—for your business, your stakeholders, and your peace of mind. 

Learn more about our team and services.  

Article
Selecting the right auditor: Eight questions to ask

Read this if you work in management at a higher education institute or another nonprofit organization. 

On May 5, 2025, the US Department of Education (ED) issued a Dear Colleague Letter (DCL) to higher education institutions. The DCL outlined current default rates for federal student loans and the expected impact on these rates with the resumption of collection efforts on defaulted loans. ED suspended collection efforts on these loans in March 2020 to help combat the economic crisis created by the COVID-19 pandemic. According to ED, an estimated 25% of individuals currently in repayment are in default or significantly delinquent. It’s important to take a closer look at the impact increased default rates could have on higher education institutions and other nonprofit organizations, and how to remain compliant. 

Impact on higher education institutions 

Federal regulations require higher education institutions to track and maintain low cohort default rates (CDR). If an institution has a CDR higher than 40% in a single year or exceeds 30% for three consecutive years, the institution will lose their eligibility to receive federal student assistance. ED’s resumption of collection efforts on defaulted federal student loans is expected to increase institutions’ CDR.  

The DCL emphasizes the role institutions play in contacting former students to remind them of their responsibility to repay their federal student loans. If an institution were to become ineligible to receive its annual federal student assistance, funding would severely impact the institution’s ability to continue operations.  

The CDR regulation is three years in arrears, which means the 2026 default rate will include students who entered into repayment in 2023. Based on this, institutions should: 

  • Start contacting former students in repayment before 2026 to help them avoid defaults 
  • Monitor their CDR continuously to mitigate the risk of becoming noncompliant with federal regulations and to reduce the risk of losing eligibility to receive federal student assistance funding 

Impact on other nonprofit organizations 

While higher education institutions bear the direct impact of increased default rates on federal student loans, other nonprofit organizations should also be aware of how these defaults could affect their operations. Many former students with federal student loans work at nonprofit organizations, which often receive various forms of federal assistance. These organizations must verify that federal funds are not paid to businesses or individuals, including employees, who are suspended or debarred by the federal government. This is because suspension or debarment can result from defaulting on federal student loans, as well as for other reasons.  

As more individuals are expected to default, the list of those debarred or suspended from receiving federal payments could grow. Nonprofits are required to periodically review their vendors and employees to verify they are not suspended or debarred. If identified as such, these vendors and employees would be ineligible to receive any payment for goods or services, including wages, through federal funding, including Medicaid.

It's crucial for nonprofit organizations to regularly monitor the suspension and debarment list, which frequently changes, to maintain compliance. Organizations can support their employees by communicating the importance of making student loan payments and avoiding default. Helping employees understand how their student loan payments can impact their employment may encourage timely payments and prevent defaults.  

With collection on default federal student loans back in effect, it’s imperative that higher education institutions and other affected nonprofits follow these strategies to ensure compliance. Learn more about BerryDunn’s team and services. 

Article
Collection on defaulted federal student loans: Impact on nonprofits

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.

Major tax provisions

At the heart of the legislation is a sweeping restructuring of federal tax policy. The bill seeks to permanently extend key tax cuts from 2017, while also introducing temporary incentives aimed at stimulating economic growth.

  • Locking in individual and estate tax cuts.
  • Tax reductions from the 2017 Tax Cuts and Jobs Act (TCJA) will become permanent, preventing their previously scheduled expiration.
  • The estate tax exemption will rise to $15 million, adjusted for inflation, allowing high-net-worth individuals to transfer wealth with fewer tax burdens.

Temporary benefits for workers and families (expiring in 2028)

Acknowledging the financial pressures facing American households, the bill introduces several temporary tax incentives:

  • Exemptions on tips and overtime compensation, providing relief to service workers and those reliant on extra income.
  • Tax-exempt status for interest on specific US-assembled automobile loans, potentially lowering borrowing costs.
  • An increase in the standard deduction: an additional $1,000 for individual filers ($16,000 total) and $2,000 for joint filers ($32,000 total).
  • A boost to the child tax credit, raising it by $500 to $2,500 per child for tax years 2025 through 2028.

Expanding deductions for high-tax states

One of the bill’s most anticipated revisions is its adjustment of the state and local tax (SALT) deduction cap:

  • The cap will increase from $10,000 to $40,000 for households with adjusted gross incomes up to $500,000, alleviating tax burdens in high-tax states.
  • For higher-income earners, the deduction gradually phases down, limiting revenue losses for the federal government.

Business tax reforms and incentives

Businesses are among the biggest beneficiaries of this legislation, with several key tax advantages aimed at stimulating investment and innovation.

Encouraging capital investments

  • The bill restores 100% bonus depreciation for eligible assets acquired between January 20, 2025, and 2029, allowing businesses to fully deduct the cost upfront.
  • The Section 179 deduction cap is raised to $2.5 million, encouraging companies to reinvest in equipment and infrastructure.
  • Pass-through entities will see a qualified business income (QBI) deduction increase from 20% to 23%, reducing tax liabilities for small business owners.

Modernizing research and development (R&D) tax treatment

To foster innovation, the legislation reshapes R&D deductions:

  • Businesses investing in domestic research can either deduct costs immediately or amortize them over 60 months.
  • Foreign R&D costs remain unchanged, reflecting concerns about outsourcing innovation.

More favorable business interest deductions

Under IRC Section 163(j), companies can now add back depreciation, amortization, and depletion when calculating limits on interest deductions, helping firms that rely on capital financing.

Controversial provisions and policy shifts

While many business owners welcome the tax incentives, other aspects of the bill have sparked debate—particularly those affecting environmental initiatives and international taxation.

Scaling back clean energy tax credits

Several clean energy tax credits from the Inflation Reduction Act (IRA) are now subject to elimination or accelerated phase-out.

  • Supporters argue that this move reduces unnecessary subsidies.
  • Environmental groups warn that these rollbacks could slow the transition to renewable energy and discourage green investments.

Targeting "unfair foreign taxes"

A new provision, Proposed Section 899, is designed to address foreign tax policies:

  • It imposes higher US tax rates on individuals from nations that impose restrictive or unfair taxes on American citizens or corporations.
  • Critics view this measure as potentially fueling trade tensions and diplomatic disputes.

Excise tax on remittances

A 3.5% excise tax will now apply to remittances sent by non-US citizens to family members abroad.

While proponents frame this as a revenue-generating strategy, opponents argue that it disproportionately affects immigrant communities.

What happens next?

As the bill moves to the US Senate, its fate remains uncertain. While Republicans tout its provisions as an economic boost, Democratic lawmakers continue to scrutinize its potential effects on income inequality, environmental sustainability, and trade relations.

Taxpayers—whether individuals or businesses—should pay close attention as amendments emerge. With negotiations underway, the final legislation could see additional revisions, altering tax credits, deductions, and corporate incentives.

For now, those impacted by the bill should begin assessing how these provisions align with their financial strategies, preparing for potential tax shifts in the coming years.

BerryDunn's tax consulting and compliance team brings deep experience and extensive resources to each client’s unique tax situation. We work closely with you to develop comprehensive, coordinated strategies to ensure tax compliance, limit exposure, and optimize performance. Learn more about our team and services. 

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Major tax law changes ahead: What you need to know now