Blog

»  Posts By   November 2016 

Utilizing the Federal “Any Willing Provider” Law

    Plan sponsors and Pharmacy Benefit Managers (PBMs) routinely exclude pharmacies from Medicare Part D networks, whether through closed specialty pharmacy networks or "preferred" pharmacy networks. However, under the Medicare framework, the federal "Any Willing Provider" (AWP) law requires plan sponsors and PBMs to admit any pharmacy that meets the terms and conditions. Join Jonathan Levitt, Esq., as he demonstrates how your pharmacy can utilize the AWP rules to...

Physician Integration Strategies: Super Groups, Clinically Integrated Networks (CINs) and Alternative Payment Models

In order for small, private medical practices to survive and thrive in the current healthcare environment, with the increased emphasis on cost, quality and compliance, most physicians will likely need to become part of larger networks of physicians able to engage in alternative payment relationships with commercial insurers or self-insured employer plans as a group. These groups must be sufficiently integrated to avoid a Federal anti-trust violation, and to be...

Physician-Ancillary Provider Relationship Strategies Video Presentation

Physician-Ancillary Provider Relationship Strategies: How to Structure Arrangements That Comport with Federal Anti-Kickback, Stark and Licensing Issues In this presentation from the "Business of Pain Medicine Symposium: 21st Century Challenges and Solutions" event held October 7th - 9th 2016 in Washington, D.C., John Morrone, Esq., addresses opportunities for physicians and physician group practices to integrate various ancillary services into their practices, including, but are not limited to, laboratory, pharmacies, Durable Medical...
12