National Expert in Medicare Regulatory Matters
CEO & Managing Director, Loria Associates, LLC
Based in Montgomery, Texas – Available Nationwide

With over 50 years of healthcare industry experience, Lance S. Loria is a nationally recognized expert in Medicare reimbursement, billing compliance, healthcare fraud, and regulatory litigation. A seasoned CPA and healthcare executive, Mr. Loria offers a rare depth of knowledge in complex Medicare disputes, False Claims Act litigation, Anti-Kickback Statute compliance, and provider billing controversies.

Mr. Loria has managed and resolved more than 2,000 Medicare-related investigations and appeals, representing hospitals, skilled nursing facilities, physician groups, laboratories, home health, and hospice providers. His work includes cost report audits, statistical sampling and extrapolation analyses, managed care pricing disputes, and regulatory reviews involving physician contracts, clinical documentation, and medical necessity.

He frequently serves as an expert in civil and criminal litigation, including Provider Reimbursement Review Board (PRRB) matters, Administrative Law Judge (ALJ) hearings, arbitration, and mediation. Known for his ability to identify case-critical details overlooked by others, Mr. Loria is often regarded as the “difference-maker” in high-stakes legal proceedings.

Before founding Loria Associates in 2002, Mr. Loria was the National Director of the Regulatory Practice at Ernst & Young and later served as a Partner in the Southwest Healthcare Practice at PwC, where he advised national healthcare systems on compliance, billing integrity, and audit defense strategies.

He is the longtime author of the leading “Cost Report Compliance” chapter in the Compliance Professionals Manual published by the Health Care Compliance Association and Wolters Kluwer. In addition, he has published more than 100 articles, delivered over 120 industry presentations, served as a book reviewer and editor for healthcare finance publications, and held leadership roles across multiple professional organizations.

Credentials & Honors

• CPA (Certified Public Accountant)

• LFACHE (Life Fellow, American College of Healthcare Executives)

• FAAMA (Fellow, American Academy of Medical Administrators)

• Inducted into the Stetson University Accounting Hall of Fame

• Recipient, National Service Award – ACHE

• Founders Medal of Honor – HFMA

• U.S. Army Reserve, Captain (1972–1980)

Education
B.S. in Accounting – Stetson University

From hospital audit disputes to federal billing investigations, Lance S. Loria offers attorneys clear, credible, and defensible expert opinions grounded in unmatched regulatory expertise and litigation experience.