Self-regulation by the medical profession is separate and distinct from the conventional rules exercised by the judicial system. Peer review and disciplinary matters are generally heard before the Medical Executive Committee (“MEC”) at Hospitals... Read More
Restrictive covenants in employment agreements are a critical tool utilized by employers to impose post-employment restrictions on their employees. Restrictive covenants are enforceable to preserve and protect the employer’s confidential... Read More
On April 26, 2021 the Office of Inspector General (“OIG”) in the U.S. Department of Health and Human Services (“HHS”) issued a new Advisory Opinion Letter providing its analysis as to whether a “Proposed Arrangement” involving an... Read More
On April 6, 2021, New Jersey Attorney General Gurbir Grewal issued AG Administrative Directive 2021-3 (the “Directive”), that focused on addressing sexual misconduct issues by licensees of all 51 New Jersey licensing boards. These new... Read More
Physician groups contracting with government-regulated health plans such as Medicare-Advantage Organizations, Medicaid Managed Care Organizations, or ACA Marketplace Individual/Small Group Issuers often enter into capitated payment models with... Read More
Frier Levitt Podiatrist-Attorney, Lawrence F. Kobak, DPM, Esq. has authored an article in the current edition (May 2021) of Podiatry Management about DPM vs. DPM and feuds between podiatrists. We all know of feuding podiatrists. Frequently, they... 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
Following the release of an April 16, 2021 HHS Office of Inspector General (“OIG”) report entitled “Medicare Advantage Compliance Audit of Diagnosis Codes that Humana, Inc. (Contract H1036) Submitted to CMS” (the “OIG Report”), headlines... Read More
The United States Attorney’s Office for the District of Massachusetts recently settled a case against an otolaryngology practice and its management company involving improper billing for certain office visits and procedures. Medicare and... Read More
New Jersey businesses are governed by some of the most comprehensive employment laws in the country. Employers in regulated sectors must pay even more attention to their actions to avoid allegations of wrongdoing by their employees. Employers must... Read More
