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NJ Client ALERT: Gabapentin Prescribing Receiving Higher Scrutiny Under New Evidence of Abuse

On May 7, 2018, the New Jersey Division of Consumer Affairs began requiring pharmacies begin reporting prescriptions for the unscheduled drug gabapentin to the New Jersey Prescription Monitoring Program (PMP). The drug, known under brand names Neurontin and Gralise, is currently unscheduled. However Michigan, Ohio, Kentucky, and West Virginia have all reclassified gabapentin as Schedule V, while other states are currently debating whether to schedule gabapentin as well. It has...

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...

NY Anesthesiologist Indicted in Telemedicine Healthcare Fraud Scheme

A New York anesthesiologist was indicted on July 9 for her participation in an alleged telemedicine conspiracy to submit fraudulent claims to Medicare, Medicare Part D, and private insurance plans. The physician was charged with one count of conspiracy to commit healthcare fraud. According to the indictment, the physician, along with other providers, participated in a fraudulent scheme to order and prescribe Durable Medical Equipment (DME) and prescription drugs through...