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»  Posts By   May 2017 

CLIENT ALERT: Responding to CMS and Private Payor Record Requests and Audits

A recent report highlighting a $1.9 Billion Recovery by the OIG MFCUs (Medicaid Fraud Control Units) in Fiscal Year 2016 underscores the aggressive nature of government audits. Frier Levitt has experienced a considerable increase in private payor audits against our clients, and is monitoring the trend carefully.  Frier Levitt remains in contact with our professional liability insurance company partners and specialized consultants to ensure that we continue to provide a comprehensive and well-coordinated defense for our clients. If your...

Government Investigations: When Not Responding is a Non-Option

It is not uncommon for multiple, or even parallel, investigations into the same provider to take place concomitantly. To be sure, oftentimes, a pharmacy or physician practice is served with a government's investigative demand for documents or testimony only to be served with another demand by a different investigating agency or governmental body shortly thereafter. These investigations can be criminal, civil, or administrative in nature.  A recent case out of...

False Claims Act Defendants Need Not Always Play Defense – Defendants Can Countersue Whistleblowers Under Certain Circumstances

The number of False Claims Act (FCA) whistleblower actions filed has risen steeply in recent years, as the Federal government has stepped up its scrutiny of healthcare provider billing practices and personal injury attorneys have found a profitable new niche in representing provider employees who seek to blow the whistle on their employers as FCA "qui tam" relators. Providers accused of FCA violations should know, however, that they are not without the...

Frier Levitt Adds Daniel Giaquinto, Esq. and Guillermo Beades, Esq., Bolstering Their Liability and Regulatory Practice Group

As part of its continued expansion into the healthcare regulatory field, Frier Levitt announced today the hiring of two of the region's most reputable healthcare attorneys, Daniel G. Giaquinto, Esq., and Guillermo J. Beades, Esq. Already considered a national leader in healthcare regulatory as well as transactional matters, the new hires add even further depth to Frier Levitt. Mr. Giaquinto and Mr. Beades join the firm's Healthcare Regulatory Practice Group,...

Express Scripts Leverages Limitations on Pharmacy Practice to Terminate Network Pharmacies

With the potential of losing Anthem as its largest single customer, Express Scripts (ESRX) has created multiple tactics to terminate network independent pharmacies in an effort to drive prescription volume to their own mail order and Specialty Pharmacies. An example of one such tactic being employed by ESRX utilizes the limitations of pharmacy practice itself. In July 2016, ESRX made a minor amendment to an innocuous section of its Provider...
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