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Our mission is to provide the support that digital health innovators need to break the barriers, mitigate uncertainties, and feel free to innovate, charting the course towards new healthcare delivery models

DIGITAL
HEALTH

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.

FOCUS ON
HEALTHCARE

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

PHARMACY
EXPERTS

Experienced, dedicated and well-tested litigation attorneys who enjoy the challenges of the courtroom

DEDICATED
LITIGATORS

When you need attorneys who know and understand your business, not just the letter of the law

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Opioid Litigation Update: Invasive Subpoenas Issued to Pharmacies; Information Regarding RDC Sought
The New York State opioid litigation, led by private plaintiffs and the Office of the Attorney General of the State of New York, has taken another turn.Plaintiffs' counsel has now issued subpoenas to ...
Important Client Alert - OptumRx Provider Manual Update
IMPORTANT CLIENT ALERTThe latest edition of OptumRx (ORX) Provider Manual (2019 4th Edition) contains significant new provisions pertaining to maintenance of records by pharmaci...
Sauchik & Giyaur, P.C. secures reversal of network termination of five providers
Sauchik & Giyaur, P.C. (the "Firm") recently secured reversal of network terminations for five providers, ensuring that the providers continued as participating providers. The individual providers...
PharmacyFirst's Participants Are Hit With GER Clawbacks
Pharmacies are urged to take immediate steps to challenge PharmacyFirst's actions in connection with so-called "GER" adjustments. GER ("Generic Effective Rate") provisions were ...
Alec Sauchik selected to join the Health Law Committee of NYCBA
Alec Sauchik, Esq. has been selected to serve on the Health Law Committee of the New York City Bar Association for the 2019-2022 term.  The Health Law Committee i...
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Opioid Litigation Update: Invasive Subpoenas Issued to Pharmacies; Information Regarding RDC Sought

The New York State opioid litigation, led by private plaintiffs and the Office of the Attorney General of the State of New York, has taken another turn.Plaintiffs' counsel has now issued subpoenas to thousands of New York State-based pharmacies who are not parties to the litigation.These subpoenas . . .

In News and Updates

Important Client Alert - OptumRx Provider Manual Update

IMPORTANT CLIENT ALERT

The latest edition of OptumRx (ORX) Provider Manual (2019 4th Edition) contains significant new provisions pertaining to maintenance of records by pharmacies.We expect that, in . . .

In News and Updates

Sauchik & Giyaur, P.C. secures reversal of network termination of five providers

Sauchik & Giyaur, P.C. (the "Firm") recently secured reversal of network terminations for five providers, ensuring that the providers continued as participating providers. The individual providers, who were part of the same practice, had received abrupt network termination notices from a prominent . . .

In News and Updates

PharmacyFirst's Participants Are Hit With GER Clawbacks

Pharmacies are urged to take immediate steps to challenge PharmacyFirst's actions in connection with so-called "GER" adjustments. GER ("Generic Effective Rate") provisions were added in the past year to agreements between Caremark and . . .

In News and Updates

Alec Sauchik selected to join the Health Law Committee of NYCBA

Alec Sauchik, Esq. has been selected to serve on the Health Law Committee of the New York City Bar Association for the 2019-2022 term.  The Health Law Committee is comprised of attorneys of highly varied backgrounds who . . .

In News and Updates

Visit us in Vegas!

Wynn Hotel and Resort

Las Vegas, NV

We will be highlighting our services and expertise at the Asembia Specialty Pharmacy Summit 2019. Please join our attorneys . . .

In News and Updates

Medicaid Providers, Beware: OMIG Places Provider Compliance Programs Under Review

The NYS Office of the Medicaid Inspector General ("OMIG") has dramatically increased enforcement activity in connection with Medicaid provider compliance programs: OMIG is notifying providers that their compliance programs are being placed . . .

In News and Updates

The SUPPORT Act - Providers Need to Take Notice

On October 24, 2018, the President signed a new bill aimed at combating the opioid addiction epidemic that is sweeping the nation - the SUPPORT Act of 2018.  The full Congressional summary of the the . . .

In News and Updates

The Importance of Fresh Perspectives When Challenging PBM Audit Findings and Termination Notices

It is a familiar story - a pharmacy provider receives a PBM termination notice or audit findings, believes that nothing can be done, and gives up the fight.  Providers often fall into the trap of accepting PBM's narratives and not . . .

In News and Updates

A New Jersey Pharmacy Owner Charged With “Cash Skimming” Conspiracy – Is Your Pharmacy at Risk?

A New Jersey owner of several pharmacies was charged by indictment and arraigned today on charges of conspiracy to defraud the IRS by engaging in a "cash skimming" scheme.  The indictment alleges that the pharmacy's owner, . . .

In News and Updates

Importance of Addressing Third-Party Audits Properly

Third-party audits have the potential to wreak havoc on independent pharmacies.An audit on its own can be extremely costly due to time dedicated to gathering necessary documents and assisting the auditor.  Further, any discrepancies . . .

In News and Updates

Medicare Appeals Backlog – Light at the End of the Tunnel?

The number of Medicare appeals cases pending to be heard by administrative law judges has been growing exponentially.  The backlog is now almost ten times larger than it was five years ago and is projected to reach two million . . .

In News and Updates

Merger Mania: Exploring the Impact of ESI/Cigna and CVS/Aetna Mergers on Independent Pharmacies

In a ground-shaking two weeks, the Antitrust Division of the U.S. Department of Justice approved multiple PBM/insurer mergers: first, the merger of Express Scripts Inc. and Cigna, and now, the merger of CVS Health (formerly CVS Caremark) . . .

In News and Updates

DOJ APPROVES CIGNA-EXPRESS SCRIPTS MERGER

This is the time for independent pharmacies to be actively preparing for the impact of the Cigna-ESI merger—and the ensuing Aetna-Caremark merger—if they have not already done so.

The Antitrust Division of the U.S. . . .

In News and Updates

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

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