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»  Posts By   August 2018 

PHARMACY ALERT: OptumRx Sends “Notice of Potential Contract Breach” Regarding Buying from Non-VAWD Wholesalers

OptumRx is sending out a "Notice of Potential Contract Breach" to pharmacies in its network advising that the pharmacy is in breach of their agreement because the pharmacy is alleged to have purchased from non-VAWD accredited wholesalers and distributors. The Notice further requires the pharmacy to acknowledge, in writing, that purchasing from non-VAWD accredited wholesalers constitutes a Prohibited Activity under the parties' agreement and to affirm that the pharmacy will...

NYS Appellate Division, Second Judicial Department Upholds Invalidation of a Physician’s Restrictive Covenant

In a recent decision by the New York State Supreme Court, Appellate Division, Second Department the court upheld a lower court ruling striking down a restrictive covenant against a surgeon and refusing to modify the offending restriction. In Long Island Minimally Invasive Surgery, P.C. v. St. John's Episcopal Hospital, Long Island Minimally Invasive Surgery, P.C. (the "Practice") had filed suit for breach of an employment agreement against St. John's Episcopal...

Frier Levitt Successfully Appeals Payor’s Termination of Physician

Frier Levitt recently represented a physician facing termination as a participating provider with a major commercial payor due to a medical malpractice settlement that was deemed to indicate a quality of care issue. With the payor's members comprising the majority of the physician's patient population, a termination of his provider contract would have devastated his practice and the community he serves. Frier Levitt assisted the physician in appealing the termination...

Department of Justice Brings HEAT to New Jersey in the Form of the Medicare Fraud Strike Force

On Monday, August 13, 2018, the United States Justice Department (DOJ) announced the formation of the Newark/Philadelphia Regional Medicare Fraud Strike Force (Regional Strike Force), a successor to the Health Care Fraud Prevention & Enforcement Action Team (HEAT). The HEAT Strike Force has been focusing its efforts on 10 cities across the United States including Miami, Los Angeles, Detroit, Houston, Brooklyn, Baton Rouge, New Orleans, Tampa, Chicago, and Dallas. The...

CLIENT ALERT: Compliance with New Jersey’s New Out-of-Network Law

On June 1, 2018, New Jersey Governor Phil Murphy signed the "Out-of-network Consumer Protection, Transparency, Cost Containment and Accountability Act" into law.  The law contains a number of provisions which will have a serious impact on all licensed New Jersey healthcare providers, as well as healthcare facilities such as Ambulatory Surgical Centers (ASCs). Many medical practices and healthcare facilities have excellent internal controls ensuring that patients understand their financial commitments,...
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