As the nation reels from the heartbreaking COVID-19 pandemic, scrutiny of Skilled Nursing Facilities and Long-Term Care facilities is all but certain to continue. Industry leaders and recent data suggests providers anticipate enhanced oversight from... Read More
Since the onset of the COVID-19 public health emergency in March 2020, healthcare providers have operated under a variety of waived or relaxed regulatory requirements, particularly as it relates to licensing, telehealth, and Medicare and Medicaid... Read More
On June 12, 2021, a federal District Court in Texas dismissed a case filed by employees of Houston Methodist Hospital’s (the “Hospital”) challenging the Hospital’s mandatory COVID-19 vaccination policy. Bridges, et al v. Houston Methodist... Read More
During the past year, the COVID-19 pandemic has illuminated, more than ever before, the critical role government agencies have in virtually all aspects of our lives, including public health. The Freedom of Information Act (“FOIA”), 5 U.S.C. §... Read More
In January 2020, the declaration of COVID-19 as a public health emergency relaxed certain billing requirements. See 42 C.F.R. 422.100(m) (describing requirements applicable to services provided during a disaster or emergency). These areas, as... Read More
Early in the COVID-19 outbreak, on April 2, 2020, the Centers for Medicare and Medicaid Services (“CMS”) issued a suspension of most of their audit activities. This suspension was in place until August 5, 2020, when most audit activities... Read More
As we reported here, Pharmacy Benefit Managers (“PBMs”) have been conducting series of audits on prescription claims that were submitted by pharmacies during the novel coronavirus (“COVID-19”) pandemic. The same trend has been observed in... Read More
In the recent months, Frier Levitt has noticed a significant spike in the number of audits conducted by Pharmacy Benefit Managers (“PBMs”) on prescription claims submitted by the pharmacies during the novel coronavirus (“COVID-19”)... Read More
With the onset of the pandemic and the flood of claims submitted by providers to government payors in connection with it – such as claims for COVID testing or upwardly (risk) adjusted PMPM capitation payments – comes substantial risk for the... Read More
In what may be the first of many lawsuits, a New Mexico county prison guard has filed a lawsuit challenging a directive requiring all first responders to receive a COVID-19 vaccine as a condition of continued employment. The lawsuit is particularly... Read More
