Recently, the State of New Jersey, Office of the Attorney General, Division of Consumer Affairs (“DCA”) has issued a “SCAM ALERT” with the following, warning all licensed professionals that: “Individuals impersonating New Jersey Division... Read More
This firm, in a series of articles, has made clear the importance of maintaining accurate information regarding physician profiles in the National Practitioner Data Bank ("the NPDB"), a database operated by the U.S. Department of Health and Human... 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
As all providers know, healthcare is one of the most heavily regulated industries in the United States. Unfortunately, failure to abide by these regulations may have far more wide-reaching impacts on a physician and a physician’s practice than... Read More
Early in the COVID-19 outbreak, on April 2, 2020, the Centers for Medicare and Medicaid Services (“CMS”) issued a suspension of most of their audit activities. This suspension was in place until August 5, 2020, when most audit activities... 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
Over 93% of all doctors accept Medicare, meaning that most physicians have some contact with the Centers for Medicare and Medicaid Services (“CMS”). Like private health insurers, CMS has multiple tools at its disposal to audit providers and... Read More
COVID-19 is producing mixed results for health insurance companies and their bottom line. Amongst the worst performers in 2020 is Horizon Blue Cross Blue Shield of New Jersey (“Horizon”). According to a recent report by Modern Healthcare,... Read More
On September 1, 2020, the American Medical Association (“AMA”) updated codes for office and outpatient visits. These recent updates include: Elimination of history and physical exam elements for code selection; Code selection based on... Read More
On April 1, 2020, Governor Phil Murphy signed Executive Order 112, authorizing the Director of Consumer Affairs (“Director”) to reactivate the licenses of recently retired health care professionals temporarily. The Executive Order applies to... Read More
