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How Medical Practices Should Respond to an Audit or Request for Documents

Payors audits are at an all-time high. Private payors employ third-party analytical firms to constantly run reports to find "outliers" and practices with coding aberrancies. While some audits are routine and pursuant to provider agreements, others could expose practices civilly and criminally. In order to properly triage an audit and determine how to address it, it is recommended that every practice engage in "preventative medicine": Practice Policies and Procedures Every...

Frier Levitt Obtains $500K Reduction for Physician in Overpayment Audit

A New Jersey physician was recently charged with having received over $1MM in overpayments by a large commercial private payor. After working closely with the physician and consulting with an expert certified professional coder, Frier Levitt asserted the physician's rights under New Jersey law, obtaining a reduction of $500k from the overpayment demand. Frier Levitt was also able to put in place a long-term payment plan with the payor for...

Frier Levitt Successfully Defends Three Physicians Before the Board of Medical Examiners

Recently Frier Levitt defended three medical professionals facing patient allegations. These New Jersey physicians: an orthopedic surgeon, a pulmonologist, and a hematologist & oncologist were due to face before the Board of Medical Examiners as the Board investigated the matter. Frier Levitt reviewed the case and submitted formal documents explaining the patient care provided by each physician and clarified misinterpretations of claims made by their patients. Through Frier Levitt's strategy...

What I Learned from a Federal Prosecutor Law Seminar: Pharmacies Under the Microscope in 2018 – Opioid Prescribing and Beyond

During a recent seminar on Federal and State Enforcement Priorities in 2018, Assistant United States Attorneys from the Eastern District of Pennsylvania spoke about the heightened criminal and civil scrutiny on pharmacies in the Commonwealth of Pennsylvania. Regarding the cause celebre – opioid prescribing – the focus will expand from the physician prescribers to the pharmacists and pharmacies. Opioid compliance plans will be essential for pharmacies to avoid criminal prosecution...

Frier Levitt Succeeds in Defending Physician Before Board of Medical Examiners

Frier Levitt recently represented a physician facing allegations of battery for failure to obtain consent before the Board of Medical Examiners. After a formal submission that explained the patient care provided, Frier Levitt clarified misinterpretations of the patient's account and provided documentation in support thereof. Frier Levitt had secured the closure of the case before the Board of Medical Examiners without the filing of disciplinary action and the matter will...