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»  Posts By   July 2019 

Frier Levitt Successfully Defends Physician Facing OPMC Allegations

Frier Levitt recently represented a New York Physician facing allegations with the Office of Professional Medical Conduct (OPMC). A patient had accused our client of being physically and verbally inappropriate. Using hospital records, Frier Levitt demonstrated that the patient continued to see the physician well after the alleged incidents and that the only complaint was made after the patient was dismissed from the practice. If you are a physician or...

False Claims Act Update: Enforcement in the Health Care Sector is White Hot

On July 22, 2019, the United States Department of Justice (DOJ) filed a Complaint-In-Intervention in Federal court in New York against medical device manufacturer Life Spine, Inc. and two members of its executive management team alleging violations of the False Claims Act (FCA). The DOJ and the Relator (four former Life Spine employee whistleblowers) contend that defendants engaged in an illegal kickback scheme by paying surgeons millions of dollars in...

New York’s Highest Court Reaffirms that Insurers May Deny Claims from Professional Corporations that are Improperly Controlled by Non-Physicians

New York's Court of Appeals recently upheld prior rulings, statutes, and regulations in order to confirm that only licensed physicians may practice medicine in New York. The Court's ruling in Caruthers v. Progressive Insurance Co. (2019 Slip Op 04643) upheld the finding in the much-cited case of State Farm Mut. Auto. Ins. Co. v. Mallela (4 NY3d 313 [2005]) that an insurer may withhold payment for medical services provided by...

Frier Levitt Recovers Over $300K in GER Withholdings From PSAO

Frier Levitt recently recovered over $300K held in reserve from a Pharmacy Services Administrative Organization (PSAO), which withheld the funds to due to Generic Effective Rate (GER) adjustments for the calendar year 2018. This is another major win for an independent pharmacy that suffered grave financial harm. Many pharmacies have begun receiving notices of GER adjustments, ranging from thousands to millions of dollars, without having an opportunity to examine any...

Drug Return Company Ordered to Pay $94 Million in Restitution and $15 Million in Fines for Refund Scheme

Earlier this month, a Pennsylvania federal judge ordered Devos Ltd., a drug return company, to pay over $94 million in restitution and $15 million in fines for failing to channel refunds back to customers and keeping the money for itself. Devos, which does business as Guaranteed Returns, offers middleman services to pharmacies and government agencies who are looking to take advantage of buy-back refunds from drug makers. Instead of issuing...