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Healthcare

Financial management and accounting solutions for healthcare businesses

Do You Owe Wages for the Hours Your Employee Spent Sleeping? FLSA Sleep-Time Rules for 24-Hour Shifts and Live-In Workers

Federal law lets employers exclude up to eight hours of sleep time from a shift of 24 hours or more — never from a shorter one — and only with adequate sleeping quarters, usually uninterrupted sleep, and an agreement. Every interruption is paid, and fewer than five consecutive hours of sleep makes the entire window compensable.

IRMAA for Business Owners: The Two-Year Lookback, the 2026 Medicare Brackets, and the SSA-44 Appeal

Medicare's IRMAA surcharge sets your 2026 Part B and Part D premiums from your 2024 tax return, and crossing a bracket by one dollar triggers the full tier — up to roughly $14,000 a year above standard premiums for a couple. Here is how business sales, Roth conversions and RMDs trigger it, the 2026 thresholds, and how to file Form SSA-44 after retirement or another qualifying life-changing event.

After the DMEPOS Freeze: What the 2026 CMS Fraud Crackdown Means for Your Medical Supply Business

CMS froze new DMEPOS Medicare enrollment from February 27 to August 27, 2026, barred 11 suppliers tied to $3.4 billion in suspected fraudulent billing, and suspended $5.7 billion in Medicare payments during 2025. Here is what actually changed for legitimate medical supply businesses and the seven billing and bookkeeping controls that keep claims paid and supplier numbers intact.

The New Medicare ABN Form (CMS-R-131): A Chiropractic Practice Audit Guide

CMS released an updated Advance Beneficiary Notice of Noncoverage (Form CMS-R-131) on March 13, 2026, mandatory for fee-for-service providers since May 12, 2026. With chiropractic improper payments at 30.4% and nearly 90% of those errors from insufficient documentation, this guide covers ABN trigger points, the GA/GZ/GY modifiers, and the bookkeeping that turns signed notices into collected cash.

The $120,000 Fertility Benefit: How to Account for America's Newest Standalone Employee Benefit

A proposed federal rule would let employers offer fertility coverage as a standalone excepted benefit — like dental or vision — capped at a combined $120,000 lifetime maximum per participant and covered beneficiaries, for plan years beginning on or after January 1, 2027. Here is how the fully insured and self-funded options differ on the books, and the ledger accounts, payroll deduction codes and accumulator reports to set up before the first enrollment.

California SB 351: How Dental and Med Spa Practices Must Rebuild Their MSO/PC Books for 2026

California SB 351 took effect January 1, 2026, barring private equity and management companies from controlling clinical decisions at medical and dental practices. Because the violations it targets — percentage-of-collections management fees, clinician payroll in the MSO, patient revenue landing outside the PC — are all visible in the general ledger, compliance is largely a bookkeeping project. Here are seven ledger fixes to make now.

Medical Spa Bookkeeping: Why Your MSO/PC Split, Membership Revenue, and Injectable Inventory Need Their Own Books

Med spas that book prepaid packages as day-one revenue, expense injectables on purchase, or run the MSO and PC through one bank account produce financials that fail audits and due diligence. This guide covers keeping separate books per entity with reconciled intercompany balances, recognizing package and membership cash as deferred revenue per delivered session, capitalizing neurotoxin and filler as inventory until use, and a monthly close checklist that ties POS unearned balances, physical counts, and management fees to the ledger.