Whether representing large specialty pharmacies or small community stores, we bring our knowledge of the industry and client-centered approach to help our clients succeed in the face of the toughest challenges
Can a Physician’s Medical Judgment be Basis for a False Claims
A doctor's certification or medical judgment regarding a certain treatment can be considered "false" if the treatment is not considered "reasonable and necessary" under the government's definition, even if the terms are not defined for the specific medical treatment.
Nationwide Crackdown Charges 601 Individuals with Over $2 Billion
In a sweeping crackdown that vastly exceeded investigations of years' past, the U.S. Department of Justice and Medicare Fraud Strike Force charged 601 individuals with over $2 billion in healthcare fraud. In Brooklyn and Long Island alone, . . .
New Jersey Act Imposes New Requirements to Protect Consumers
New Jersey providers should be alert to the recently signed into law Out-of-Network Consumer Protection, Transparency, Cost Containment, and Accountability Act.The Act pertains to, and enhances, consumer protections related to out-of-network . . .
New York State Takes Action Against Abusive PBM Audits, Grants
The recently passed New York State budget bill including sweeping new protections for independent pharmacies facing PBM audits. The bill, which amends the Public Health Law, requires PBMs, when conducting audits, to accept . . .
What NYC Employers Must Know About the Safe Leave Law
The former NYC Earned Sick Time Act, popularly known as the Paid Leave Law, is now the Earned Safe and Sick Time Act. Previously, the Act obligated employers to provide a certain amount of sick leave for their employees. The . . .
New York State Imposes Limitations on LHCSA Applications
Recently, New York State implemented a two-year moratorium on the processing and approval of applications for licensure of Licensed Home Care Service Agencies ("LHCSAs").This moratorium suspends the Department of Health's processing . . .
Healthcare providers are increasingly feeling the cost of employing excluded individuals.Indeed, over the past year, the number of enforcement actions taken against physician's offices, pharmacies and other entities employing excluded . . .