Frier Levitt recently obtained a $6.25 Million settlement against a Pharmacy Benefits Manager(“PBM”) on behalf of its Plan Sponsor client (“Plan”). The Plan contracted with the PBM to administer its prescription drug program, and to... Read More
Medical Practice “Super Groups” have proliferated over the past several years because, if formed properly, they provide many advantages over traditional practice structures in the face of the paradigm shift that is occurring in the delivery of... Read More
On November 20, 2020, the Trump administration announced plans to scrap the Medicare Part D “rebate safe harbor,” which currently permits insurance middlemen called Pharmacy Benefits Managers (“PBMs”) to charge manufacturers substantial fees... Read More
HHS Permits Out-of-State Telehealth Providers to Render Certain Services Nationwide On December 3, 2020, the Department of Health and Human Services (“HHS”) announced a fourth amendment to its declaration under the Public Readiness and... 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
You may have heard the phrase "CMS investigation." Unlike a CMS audit, which is administrative in nature, a CMS investigation usually connotes a federal criminal investigation of suspected health care fraud. A CMS investigation will likely be... Read More
Frier Levitt attorneys Theresa DiGuglielmo and Guillermo Beades provided legal insights for this month's Part B News publication. Guillermo's comments can be found in the article entitled "How to craft provider contracts that deal with board... Read More
Earlier this month, the Congressional Telehealth Caucus introduced the Protecting Access to Post-COVID-19 Telehealth Act of 2020 (“Act”). This bipartisan bill will continue the current, temporary expanded use of telehealth beyond the COVID-19... Read More
On March 30, 2020, the Centers for Medicare & Medicaid Services (“CMS”) suspended most Medicare Fee-For-Service medical reviews because of the COVID-19 pandemic. This included pre-payment medical reviews conducted by Medicare Administrative... Read More
The Centers for Medicare & Medicaid Services (“CMS”) Provider Enrollment, Chain and Ownership System (“PECOS”) allows registered users to securely and electronically submit and manage their Medicare enrollment information. There are... Read More
