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Healthcare is part of our firm's DNA. We add real value to our clients' business through our in-depth understanding of the key legal, regulatory and practice-related issues.

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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

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HHS Echoes Importance of HIPAA Compliance for Closed Businesses

Recently, HHS reiterated that severe consequences can be imposed for HIPAA violations, regardless of whether a business is still operational. If HIPAA violations were committed, a business can be charged long after its doors close. Moreover, . . .

In News and Updates

CMS Updates Final Adverse Actions to Be Reported

CMS has released a list of updated final adverse actions that need to be reported to CMS in a timely fashion. The list includes, but is not limited to, certain convictions, exclusions, and revocations, regardless of whether records are expunged.  Additionally, CMS revoked certain requirements . . .

In News and Updates

Physical Therapy Practices are Growing – But Also Face Increased Challenges

2006 was a monumental year for New York physical therapists – New York State passed a law permitting physical therapists to directly treat patients without a referral from a physician, triggering an explosion of private physical therapy . . .

In CLIENT ALERTS

Compounding Pharmacies Under Scrutiny for Medicare Part D Billing Practices

OIG calls for "further scrutiny" of pharmacies and prescribers in connection with compounded drugs billed to Medicare Part D.  

Pharmacies must be prepared to aggressively defend against this latest attack on the independent retail pharmacy industry.

An . . .

In News and Updates

New York Court Decision Demonstrates Importance of Proper Audit Response

It is of utmost importance that Medicaid providers take prompt measures when under audit to avoid such consequences.

Recently, the New York Court of Appeals upheld a recoupment of funds by the NYS Office of the Medicaid . . .

In Audits & Investigations

Can a Physician’s Medical Judgment be Basis for a False Claims Action? Appellate Court Rules Yes.

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.

In . . .

In News and Updates

Nationwide Crackdown Charges 601 Individuals with Over $2 Billion in Healthcare Fraud

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, . . .

In News and Updates

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 . . .

In News and Updates

New York State Takes Action Against Abusive PBM Audits, Grants New Protections to Independent Pharmacies

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 . . .

In News and Updates

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 . . .

In News and Updates

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 . . .

In News and Updates

The Rising Cost of Employing Excluded Individuals

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 . . .

In News and Updates

Under the Travel Act, Aggressive Federal Enforcement Against Providers Expands

Q.  When does a purely state criminal law-based matter transform into a federal felony prosecution?

A.  When the Federal Travel Act (the "Travel Act") is implicated.Under the Act, a party who travels in interstate . . .

In News and Updates

FEDERAL CRACKDOWN ON PRESCRIBERS OF COMPOUNDED MEDICATIONS

A recent health care fraud guilty plea by a physician has caught the attention of prescribing physicians and the broader industry surrounding compounded medications.Under the plea agreement in New Jersey District Court, the physician . . .

In News and Updates

COMPOUNDING PHARMACIES MAY SOON HAVE NEW MARKET OPPORTUNITIES

Compounding pharmacies, one of the fastest growing sectors in retail pharmacy, may soon be able to expand the market for their products in exchange for agreeing to be placed directly under federal oversight, according to U.S. . . .

In News and Updates

PHARMACY COMPLIANCE UPDATE: GROWING YOUR MEMBERSHIP PROGRAM

Membership programs are a common tool used by retail pharmacies to grow their business. Under this type of program, a pharmacy will give member patients certain benefits, usually taking the form of rebates, discounts, or coupons on in-store . . .

In News and Updates

Medicare Fraud Strike Force Announces $1.3 Billion Healthcare Fraud Takedown

In what is becoming an annual tradition, the Medicare Fraud Strike Force, comprised of members from the U.S. Department of Justice and the Department of Health and Human Services (more about which can be read here), . . .

In News and Updates

Healthcare Industry Welcomes Changes to Overtime Wage Guidance

In a step viewed optimistically by healthcare businesses, the United States Department of Labor ("DOL") has withdrawn two Obama-era guidance letters used to interpret the overtime wage provisions of the Fair Labor Standards Act.

The . . .

In News and Updates

Final Guidance for Part D DIR Reporting Requirements: Promising Developments for Pharmacies

It appears that the Centers for Medicare & Medicaid Services ("CMS"), in its newly-released Final Guidance on Medicare Part D DIR Reporting Requirements for 2016, has begun addressing the lack of transparency surrounding Part D plan . . .

In News and Updates

Senators; New York Times Article Highlights Abuses by Treasury Department

Contractors Responsible for Collecting Debts Alleged against Medicare Providers 

A recent New York Times article, available here, . . .

In News and Updates

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