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CMS Proposed Revisions to Prescription Drug Benefit Program …

WebCMS has recently proposed revisions to the Medicare Advantage (MA) Program (Part C) and Prescription Drug Benefit Program (Part D) regulations that will

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URL: https://www.frierlevitt.com/articles/service/healthcarelaw/cms-proposed-revisions-prescription-drug-benefit-program-met-opposition/

HHS Proposes Significant Modifications to the HIPAA Privacy Rule

WebOn January 21, 2021, the U.S. Department of Health and Human Services (“HHS”) published proposed rules that would significantly modify existing On January 21, …

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HHS Announces $5.1 Million Settlement for HIPAA Breach …

WebOn January 15, 2021, the Department of Health and Human Services Office for Civil Rights (“OCR”) announced that Excellus Health Plan, Inc. has agreed to pay $5.1 million and to …

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As More Specialty Medications Hit the Market, State Legislatures …

WebState legislatures are taking steps to limit high copayment or percentage cost sharing for specialty medications that are on the market. These steps are a

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Healthcare Orgs. & Entities: What You Need to Know About …

WebTo qualify for Nonprofit status, the corporation must be formed to benefit (i) the public, (ii) a specific group of individuals, or (iii) the membership of the Non-Profit …

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Supreme Court Revisits the Chevron Doctrine – Potential Impacts …

WebAfter nearly 40 years, the Chevron Doctrine – a long-standing legal doctrine that requires courts to show great deference to agency decisions interpreting ambiguous …

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Dental Practice Agrees to $10,000 Settlement for Potential Social …

WebLast week, the Office for Civil Rights (OCR) announced a settlement related to allegations that a dental practice disclosed protected health information on its Yelp …

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The Lower Costs, More Transparency Act and Potential Impact

WebThe House of Representatives recently voted to pass a bill intended to deliver on those demands. The bill, entitled The Lower Costs, More Transparency Act …

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Impact of the Supreme Court’s False Claims Act Decision on …

WebThe two essential elements of an FCA violation are: (1) the falsity of the claim; and (2) the defendant’s knowledge of the claim’s falsity (i.e., the FCA’s “scienter” …

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Qui Tam Case Against Physicians and Hospital Advances on What …

WebA U.S. District Judge found that two agreements between a set of doctors and a University of Pittsburgh Medical Center-owned hospital ran afoul of the Stark Law …

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Management Services Organizations (MSOs)

WebAn MSO is a company that provides non-clinical services to medical practices, ambulatory care facilities or other healthcare providers. Services provided by an MSO may include …

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Healthcare Attorney Healthcare Law Firm Frier Levitt

WebHealthcare Industry Experience. Frier Levitt’s attorneys have decades of experience creating, evaluating, and negotiating arrangements that comply with the …

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Physician Integration Models: CINs. MSOs. & Integrated Group …

WebArguably the gold standard for physician integration, IGPs are entities (usually LLCs) consisting of multiple physicians (either single or multi-specialty) that …

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A Deep Dive into the CMS Audit Appeals Process: A …

WebA critical aspect of the CMS audit process is the recoupment procedure, wherein CMS may choose to recover the alleged overpayments by offsetting the …

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Medical Director Arrangements Under Increased Scrutiny

WebQuestionable medical director arrangements may run afoul of the Anti-Kickback Statute and the Stark Law. Under the Anti-Kickback Statute (AKS), it is a …

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What Johnson & Johnson's Lawsuit Against SaveOnSP Means for …

WebOn January 25, 2023, the Court in Johnson & Johnson v. SaveOnSP dismissed SaveOnSP’s motion to dismiss, allowing Johnson & Johnson’s (“JNJ”) claims to proceed. …

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Healthcare Private Equity Investing Law Firm Frier Levitt

WebFrier Levitt is experienced in representing medical and dental practices throughout and beyond the life cycle of a Private Equity transaction, including forming platform entities …

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Florida Governor Announces Pharmacy Benefit Manager (“PBM”) …

WebOn Thursday, January 12, 2023, Governor Ron DeSantis announced a legislative proposal to regulate “unchecked” Pharmacy Benefit Managers (“PBMs”) operating in Florida. …

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New Jersey Updates Employer Poster Display Requirements for …

WebThe New Jersey Division on Civil Rights (DCR) amended its regulations governing the display of certain employment-related posters in the workplace relating to …

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Why OON Providers Need a Limited Power of Attorney from Patients

WebMany OON providers utilize assignment of benefit forms so that a provider can be paid by an insurance company directly or the provider can dispute nonpayment or …

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FTC Expands PBM Investigation to PBM-Owned Rebate …

WebOn May 17 th, the FTC issued additional compulsory orders to Zinc Health Service, LLC (“ Zinc ”) and Ascent Health Services, LLC (“ Ascent ”) as part of its probe …

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WebMain Navigation. Menu. Home; About. About Us; Our Attorneys; Our Staff; What we do. Healthcare. Administrative and Insurance Defense Law

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