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»  Posts By   November 2019 

Breaking Up is Hard to Do: Separating from Your Employer Without the Drama Webinar Recording

https://www.youtube.com/watch?v=wI5dcTduQ5o For physicians, separating from an employer can present many potential issues. Knowing how to avoid common missteps can help minimize the impact on your business. In this recorded webinar, John E. Morrone, Esq., provides practical advice and discusses exiting employment contracts and re-entering private practice, including: Legal implications of exiting an employment contract Escaping the non-compete Managing non-solicitation provisions Preserving the physician-patient relationship If you are a physician with...

Pharmacy, Physician Dispenser, and Wholesaler ALERT: OIG’s Safe Harbor Proposed Rule Potentially Excludes Pharmacies, Physician Dispensers, and Wholesalers as Value Based Entity Participants

Value Based Care is the future of the United States healthcare system and the Office of the Inspector General (OIG) for the US Department of Health and Human Services is in full agreement. The OIG recently issued a Notice of Proposed Rulemaking that introduced updates to the Anti-Kickback Statute (AKS), significantly modernizing the regulatory landscape and encouraging the transition from fee-for-service reimbursement to a value-based model. The Proposed Rule aims...

Frier Levitt Saves Texas-Based Pharmacy over $1.6 Million in PBM Audit

Frier Levitt successfully saved over $1.6 Million for an independent pharmacy located in Texas against a desktop-audit conducted by a major Pharmacy Benefit Manager (PBM). The PBM claimed several different discrepancies, including inventory shortfalls, missing prescriptions, and failure to collect copays. The total amount of chargeback based on the alleged discrepancies was approximately $1.9 Million. Attorney Dae Y. Lee, Pharm.D., Esq., CPBS, conducted an extensive review of the alleged discrepancies...

Second Circuit Dicta Concerning FCA “Alternate Remedy” Provision May Create Perverse Incentive for Government to Increase Criminal Prosecution

The Second Circuit's decision in U.S. v. L-3 Communications EOTech, Inc., included ominous dicta pertaining to the "alternate remedy" provision of the False Claims Act (FCA), which may lead to an increase in government determinations to prosecute FCA matters criminally, rather than joining or "intervening" in an ongoing civil suit. The "alternate remedy" provision reads, in pertinent part, that "the Government may elect to pursue its claim [under the FCA]...

Provider ALERT: 2020 Medicare Physician Fee Schedule Includes Expansion of Revocation Authority

Upon the annual announcement of the Medicare Physician Fee Schedule, providers are typically focused on the new payment rates and policies, but the 2020 version includes an expansion of revocation authority about which all enrolled providers must be aware. The Centers for Medicare & Medicaid Services (CMS) has always retained the discretion to deny or revoke a provider's enrollment status and corresponding billing privileges for violations of CMS rules, but...