The U.S. Attorney’s Office, Western District of Louisiana, recently announced that the owner and operator of the Monroe-based Specialty Drug Testing, LLC (“Specialty”) was indicted by a Federal grand jury for violating the Federal... Read More
Healthcare | Healthcare Law | Hospitals and Healthcare Systems | Laboratories | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals

The Center for Medicare & Medicaid Services (CMS) released a moratorium on March 10, 2020 directing Medicare Advantage Organizations (MAOs), Medicare Part D Sponsors (Sponsors), Medicare-Medicaid Plans (Plans), and consequently, pharmacy... Read More
Blogs & Articles | COVID-19 Resources | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Pharmacy Law

On March 6, 2020 the Centers for Medicare & Medicaid Services (CMS) issued frequently asked questions (FAQs) and answers for healthcare providers and supplemented a February Public Health News Alert regarding Medicare payment for laboratory... Read More
Blogs & Articles | COVID-19 Resources | Healthcare Law | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals

In recent months, Medicare Advantage Organizations (MA Organizations) across the country have been on a network termination binge – often terminating physicians without sufficient (or sometimes any) notice and opportunity to appeal. These... Read More
Healthcare Law | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals

Pharmacy Benefit Managers (PBMs) own their own Specialty Pharmacies (SPs) and convince Plan Sponsors to allow the PBMs to become the exclusive provider of expensive specialty drugs.  PBMs have recently enjoyed significant revenue expansion and... Read More
Defending Pharmacies in PBM Audits | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Payor Network Access and Defense of Network Terminations | Pharmacy Law

Recently Frier Levitt pursued a Medicare appeal for a cardiology group that faced a 2.4-million dollar recoupment. Frier Levitt was able to have over 2-million dollars of the recoupment reversed at the redetermination stage (first level of appeal).... Read More
Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Pharmacy Law | Recent Successes