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Eliminate the Double Penalty for Complication Expenses in Bundled Payment Programs

A "bundled payment" is a term that refers to a single, global payment for an "episode" of care. Currently, the most common episodes are orthopedic surgical procedures (e.g. hip and knee replacements), but can include a pregnancy, a colonoscopy or even cancer.  As bundled payment programs become more common in healthcare, both the Federal and State Governments should grant "Bundlers" the right to obtain a lien on the awards in...

CMS Announces Bundled Payments for Care Improvement Advanced (BPCI-Advanced) Initiative

Recognizing that bundled payments have been a successful value-based care model, Centers for Medicare & Medicaid Services (CMS) has recently announced the details of its new voluntary bundled payment program, Bundled Payments for Care Improvement Advanced (BPCI-Advanced).  The BPCI-Advanced has multiple qualifications and features worth noting, including: Eligible Participants: Non-conveners: Acute Care Hospitals (ACH), Physician Group Practices (PGP) Conveners: Participants who bring downstream providers, "episode initiators," together (ex. may include...

CLIENT ALERT: Important Notice for Physicians Previously Insured by HPIX or NJHPIX

Frier Levitt has recently been contacted by physicians regarding a letter sent out by Healthcare Providers Insurance Exchange (HPIX). In the letter, HPIX reveals they have filed for liquidation, stating, "Our most recent independent actuarial projections, as of September 30, 2017, indicate that we may not have sufficient assets to meet our liabilities..."   The implications for anyone who has been insured in the past by HPIX and is the subject...

CLIENT ALERT: Responding to CMS and Private Payor Record Requests and Audits

A recent report highlighting a $1.9 Billion Recovery by the OIG MFCUs (Medicaid Fraud Control Units) in Fiscal Year 2016 underscores the aggressive nature of government audits. Frier Levitt has experienced a considerable increase in private payor audits against our clients, and is monitoring the trend carefully.  Frier Levitt remains in contact with our professional liability insurance company partners and specialized consultants to ensure that we continue to provide a comprehensive and well-coordinated defense for our clients. If your...