Frier Levitt has come to learn that over the last several months, certain Medicare Advantage Organizations (MAOs) have been unilaterally and substantially increasing capitated provider groups’ claims reserve period by several months, requiring... Read More
Articles | Life Sciences | Medicare Advantage Risk Adjustment Litigation | Pharmacy Law | Value Based Care

Last week the Department of Justice (“DOJ”) issued a press release touting a settlement with Silver Lake Hospital (“Silver Lake”) and Silver Lake Investors.  The DOJ alleged that Silver Lake attempted to game the Inpatient Prospective... Read More
Articles | Healthcare | Healthcare Law | Life Sciences

Providers that bill Medicare Advantage or Medicare Part C (“MA”), and most particularly capitated provider groups, should carefully watch a recent lawsuit filed by Humana, Inc. and Humana Benefit Plan of Texas, Inc. (“Humana”) against the... Read More
Articles | Healthcare | Healthcare Law

Frier Levitt has recently become aware that the New Jersey Department of Health (NJDOH) has been issuing notices to medical practices and other facilities that may offer Platelet-Rich Plasma (PRP) injections to patients for non-surgical purposes –... Read More
All types of single and multi-specialty medical practice groups | Articles | Healthcare | Healthcare Law | Healthcare Litigation | Healthcare Practice Compliance | Physicians and Medical Practices of all Specialties

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
Articles | Behavioral Health Practitioners | Dental Practices | Dispensing Physician Practices and Dispensing Physicians | Federal and State Fraud and Abuse Counseling | Healthcare Practice Compliance | Hospitals and Healthcare Systems | Managed Care Negotiations and Strategies | Medical Practice Representation | Medicare and Insurance Audits | Physicians and Medical Practices of all Specialties | Professional Practice Representation | White Collar Defense and Government Investigation

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
All types of single and multi-specialty medical practice groups | Articles | Behavioral Health Practitioners | Healthcare Practice Compliance | Medical Practice Representation | Medicare and Insurance Audits | Medicare, Medicaid, and Other Commercial Payor Audits & Appeals | Physicians and Medical Practices of all Specialties