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What Providers Need to Know About NJ DOBI Bulletin NO. 18-14 on the Out-of-Network Act

The New Jersey Department of Banking and Insurance (DOBI) recently released a guidance bulletin, Bulletin NO. 18-14  (the "Bulletin"), in an effort to provide additional guidance to carriers, health care providers, and other interested parties in order to help those entities meet their obligations under the Out-Of-Network Consumer Protection, Transparency, Cost Containment, and Accountability Act, P.L. 2018, c. 32 (codified at N.J.S.A. 26:2SS-1 to -20), (the "Act"). While the Bulletin...

Frier Levitt 2018 Regulatory Liability Annual Report

In 2017, Frier Levitt formed a practice group to defend healthcare providers against a variety of regulatory and billing liabilities that have become all too commonplace in healthcare delivery today. 2018 represented our first full year of gathering data, and we are pleased to reveal our results.   We have seen troubling new trends, such as payors alleging billing fraud (without "intent") to increase the lookback period for potential recoupment. We...

Frier Levitt Successfully Removes Fraudulent Online Physician Reviews as Trend Continues to Grow

Frier Levitt was recently successful in removing three fraudulent online reviews for a New Jersey-based medical office. Unfortunately, in an era of digital communications, it has become extremely easy for disgruntled patients to vent by making posts about physicians and their practices on social media and online review sites. Many times, these negative reviews can contain false and even defamatory information that can be damaging to a physician’s reputation, their...

The District of New Jersey’s Creative Charging Greatly Increasing Physician Criminal Exposure

When dealing with white collar crime and fraud, federal sentencing guidelines largely reflect the amount of loss sustained. When it comes to the federal Anti-Kickback Statute (AKS)- which makes it a crime to seek, offer, give or receive any remuneration in exchange for the referral of a health care service- the loss is the amount of reimbursement from a federal healthcare program (Medicare, Medicaid, Tricare, etc.) for any service during...

CLIENT ALERT: NJ Medical Practices Receive Surprise Visits from DEA, Investigators for the Board of Medical Examiners, and Local Police

In an alarming trend, representatives of the DEA, investigators who bring matters before the New Jersey State Board of Medical Examiners, and local police have been combining their efforts together to make unscheduled, surprise visits to several New Jersey medical practices. The purpose of the visits ostensibly has been to conduct an inspection or execute a search warrant. However, during the visit there has been extensive questioning, even interrogation, that...