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»  Posts By   October 2018 

Frier Levitt Successfully Reduces Recoupment from Physician’s Medicaid Audit

A New Jersey otolaryngologist was facing a large recoupment as the result of an audit by the New Jersey Medicaid Fraud Division (MFD) of the Office of the State Comptroller. In the audit, the MFD claimed that the physician was an outlier for billing too many consultation codes. Frier Levitt successfully showed that the otolaryngologist's documentation supported the use of consultations codes and that there was no basis to initiate...

What Healthcare Providers Need to Know About New Jersey’s New PTO Mandate

Earlier this year, New Jersey joined the list of many states enacting a statewide mandatory paid sick leave law. The New Jersey Paid Sick Leave Act (the Act), effective as of October 29, 2018, requires all "covered employers" to provide up to forty (40) hours of annual sick leave to their employees. The recent mandate marks a significant development for employers and employees in the state as it may require...

How Hospitals Can Prepare for S-10 Audits

As of October 1st, Disproportionate Share Hospital (DSH) eligible hospitals must now submit patient-level records for encounters that result in uncompensated charity care reported on their S-10 worksheets. Worksheet S-10 compliance is critical as the Centers for Medicare and Medicaid Services (CMS) has reiterated that there is no better proxy for the costs of hospitals for treating individuals who are uninsured despite stakeholder concerns over "inconsistent reporting" and "inadequate and unreliable...

OIG Report Shows Physicians Fail to Appeal Payment Denials 99% of the Time

An extraordinary recent Office of Inspector General (OIG) report provides objective evidence that physician groups are owed billions. As Provider advocates, Frier Levitt challenges improper claim denials by Medicare Advantage Organizations (MAOs) in Medicare Advantage (MA) capitated plans. Frier Levitt has consistently written about how MAOs deny preauthorization and claims for payment in order to increase profits, all at the expense of beneficiaries and providers. Skeptics would say our pro-provider...

Frier Levitt Successfully Defends Physician Before the Board of Medical Examiners Regarding Fraudulent Billing

Recently, Frier Levitt defended a physician before the Board of Medical Examiners facing patient allegations of fraudulent billing. Frier Levitt submitted the formal documents explaining the patient care provided by the physician and the patient's fundamental misunderstanding of the complex nature of medical billing practices. After reviewing Frier Levitt's submission, the Board closed the case without filing a disciplinary action and ensured the matter would remain strictly confidential. If you...
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