NEWS AND UPDATES
Is the Perfect Storm Against PBMs on the Horizon?
ph Recent developments suggest that significant efforts to curb abuses and harmful practices of Pharmacy Benefit Managers (PBMs) may be on the horizon. Both the Federal Trade Commission (FTC) and major media outlets have increased scrutiny on PBM practices,...
Dentist-Owned Businesses: Understanding and Complying with the Corporate Transparency Act
The Corporate Transparency Act (CTA) is a new law that affects small businesses in the U.S., including LLCs, corporations, and professional entities. Its main purpose is to help stop illegal activities like money laundering by making business ownership more...
Important Advisory for Healthcare Providers: Prohibition on the Use of Extrapolation in Medical Necessity Disputes
We would like to remind New York healthcare providers about a significant regulatory aspect that impacts the way private insurers handle medical necessity disputes in New York. This is particularly relevant for those engaged in dealing with insurance audits or...
Navigating Payment Challenges: Legal Strategies & Considerations for Home Infusion Pharmacies
Recently, home infusion pharmacies have faced formidable challenges stemming from underpayment, untimely payment, and non-payment by major medical plans for infusion therapies. This pervasive issue affects both in-network and out-of-network providers across the...
The Importance of OMIG Compliance Programs
MEDICAID/OMIG Compliance Policies and Reviews Are More Critical Then Ever Beginning July 2023, and very actively since then, NY Medicaid, through OMIG, has been conducting compliance program reviews to determine if required providers had adopted, implemented, and...
OMIG Unannounced On-Site Visits – What to Expect
In the recent weeks, the New York State Office of the Medicaid Inspector General (OMIG) has conducted numerous unannounced on-site pharmacy visits as part of their new investigative initiative. At the time of the on-site audit, a letter referring to a Credential...
Proposed New York State Law Seeks Regulatory Oversight of Healthcare Transactions Involving Private Equity
In February 2023, New York State proposed Senate Bill S4007, which aims to introduce regulatory oversight of certain healthcare transactions involving private equity firms. The proposed law would apply to various healthcare entities, including physician...
Why Your Pharmacy Needs an Employee Handbook – Today
In the world of healthcare, where precision and compliance are paramount, pharmacies stand as the vital link between physicians and the patients they serve. Yet, in the complex web of regulations, changing laws, and evolving industry standards, pharmacies must...
Alec Sauchik Selected to NYC Metro SuperLawyers 2023 for the Seventh Time
Alec Sauchik has again been named 2023 Super Lawyers, a designation awarded to only 5 percent of attorneys in the state. This is his fourth to the SuperLawyers list. Previously, Alec Sauchik was named to the SuperLawyers Rising Stars list for three years. Super...
FDA Delays Enforcement of Enhanced Drug Distribution Security Requirements: What You Need to Know
The FDA has just granted the pharmaceutical industry a one-year extension on enforcing certain enhanced drug distribution security requirements. With the original compliance deadline set for November 27, 2023, the FDA's decision comes in response to industry...