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 Beades and Jim Tudor, Director of Coding & Billing Compliance at HealthCare Compliance Network, recently had the opportunity to contribute their insights and expertise on medical payer audits to the American Health... 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
On February 9, 2023, the Centers for Medicare and Medicaid Services (“CMS”) released a memorandum (the “Memorandum”) setting forth CMS’s proposed methods for calculating so-called “Inflation Rebates” as mandated by the recent Inflation... Read More
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
A staple of Medicare and False Claims Act (“FCA”) law – the so-called “Overpayment Rule” – may soon be undergoing a dramatic shift, and doing so in a way that could increase liability for healthcare providers while potentially reducing... 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
Frier Levitt Partner Jason N. Silberberg was quoted in a Modern Healthcare article, “More MA Insurer Audits Mean More Scrutiny on Providers” by Lauren Berryman. The Final Rule set to be implemented on February 1, 2023 is likely to increase the... Read More
On June 15, 2022, the Supreme Court of the United States ruled unanimously in favor of several hospital groups concluding that the Department of Health and Human Services (HHS) exceeded its statutory authority by implementing a discriminatory... 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
