Fraud is a persistent issue in the history of U.S. healthcare. However, with the government’s decreased oversight and the implementation of telehealth billing codes and diagnostic abilities during the COVID-19 pandemic, new opportunities for... Read More
Frier Levitt Partner Guillermo J. Beades was quoted in a Part B News article, “Be Careful About Upcoding; DOJ May Come After it as a False Claim” by Roy Edroso. “It’s very rare for audits to be converted to civil or criminal actions,”... Read More
Frier Levitt successfully helped a Louisiana-based pharmacy resolve a finding for overpayment from a large insurance plan, who demanded a significant sum of money be returned to the plan on the basis that prior authorizations obtained by the... Read More
Frier Levitt recently conducted a survey of non-payment by health insurers using a sample of various in-network healthcare providers to discover patterns of non-payment, underpayment, and recoupments by public and private payors. While the plurality... Read More
The Federal Anti-Kickback Statute (the “AKS”) prohibits the payment or receipt of remuneration to induce or reward referrals of items or services reimbursable by a federal health care program (including, but not limited to, Medicare and... Read More
In part one of this article series, Frier Levitt dissected the May 9, 2022, Centers for Medicare and Medicaid Services (CMS) Final Rule (Final Rule) entitled, “Contract Year 2023 Policy and Technical Changes to the Medicare Advantage and Medicare... Read More
Two practices in Connecticut recently settled large six-figure lawsuits with federal and state agencies resolving allegations of improperly employing an individual who was excluded from all federal healthcare programs. In both instances, the... Read More
Recent CMS agency rulemaking has essentially eliminated pharmacy Direct and Indirect Remuneration (DIR) fees beginning in Plan Year 2024. Providers “in the know,” however, are not cheering. Our more technical article on the rulemaking is... Read More
On December 27, 2020, Congress enacted, and the President signed, H.R. 3630, the Surprise Act (“Act”), which will take effect on January 1, 2022. This Act expands restrictions on charging health care plan holders out-of-network rates for certain... Read More
Frier Levitt Podiatrist-Attorney Lawrence Kobak, DPM, JD shares a must read Medical-Legal Checklist for 2021 in the latest issue of Podiatry Management. He encourages practitioners to start the year off right by reviewing things such as office... Read More
