In October 2022, Pennsylvania’s former Governor Tom Wolf, before leaving office, signed House Bill 1630 (“HB 1630”) into law. HB 1630 grants the Pennsylvania Auditor General authority to audit pharmacy benefit managers (“PBMs”) that... Read More
Antitrust Tools Available to Combat PBM Abuse of Pharmacies | Articles | Defending Pharmacies in PBM Audits | DIR Fees | Managed Care Negotiations and Strategies | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Plan Sponsor PBM Contract Services

A motion to dismiss that has been pending since last year was recently decided in the matter of U.S. ex rel. Teresa Ross v. Independent Health Association, et al. The decision may very well be a bellwether for future Medicare Advantage (“MA”)... Read More
Articles | Behavioral Health Practitioners | Dental Practices | Dispensing Physician Practices and Dispensing Physicians | Federal and State Fraud and Abuse Counseling | Healthcare Practice Compliance | Hospitals and Healthcare Systems | Managed Care Negotiations and Strategies | Medical Practice Representation | Medicare and Insurance Audits | Physicians and Medical Practices of all Specialties | Professional Practice Representation | White Collar Defense and Government Investigation

On January 30, 2023, the Biden Administration announced that the COVID-19 Public Health Emergency (“PHE”), which has been in effect since January 2020, is set to expire on May 11, 2023. Considering the impending end to the PHE, healthcare... Read More
All types of single and multi-specialty medical practice groups | Ambulatory Care Facilities | Ambulatory Surgery Facilities | Articles | Behavioral Health Practitioners | Biotech Companies | Clinically Integrated Networks | COVID-19 Resources | Dental Practices | Digital Pharmacies | Healthcare Practice Compliance | Hospitals and Healthcare Systems | Integrated Delivery Network | Laboratories | Managed Care Negotiations and Strategies | Management Services Organizations (MSO) | Medical Practice Representation | Pain Management Compliance | Palliative Care, Hospice Care and Home Care | Physicians and Medical Practices of all Specialties | Professional Practice Representation | Skilled Nursing Facilities and Long-Term | Start-Up Healthcare and Life Sciences Companies | Telehealth and Telemedicine | Telehealth and Telemedicine | Urologist | Value Based Care | Value Based Care | Value Based Care Organizations: ACOs, IPAs and CINs

Palliative care is specialized medical care for people living with a serious illness, such as cancer or heart failure. Patients may receive medical care aimed at providing relief from their symptoms and improving their quality of life, while also... Read More
Articles | Healthcare | Healthcare Law | Managed Care Negotiations and Strategies | Medicare and Insurance Audits | Palliative Care, Hospice Care and Home Care | Professional Practice Representation | Telehealth and Telemedicine

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
Articles | COVID-19 Resources | Healthcare | Healthcare Law | Healthcare Litigation | Healthcare Practice Compliance | Managed Care Negotiations and Strategies | Skilled Nursing Facilities and Long-Term | Value Based Care