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MAY
20
0

Pharmacy Alert: Rochester Drug Cooperative, Following Bankruptcy, Ramps up Litigation against Pharmacies

The demise of Rochester Drug Cooperative ("RDC") continues, and this time it is retail pharmacies that must beware of the fallout. In March 2020—following numerous private, state and federal government-led lawsuits accusing RDC of being complicit in the opioid crisis—RDC filed for bankruptcy and sought to wind down its operations. As part of this, ...
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  24 Hits
24 Hits
MAY
18
0

Galderma Laboratories Lawsuits Update

Many pharmacies across the United States have received demand letters from Galderma Laboratories demanding return of funds paid in connection with the CareConnect Program.  Numerous suits have been filed in the Federal District Court for the Northern District of Texas.  Attorneys at Sauchik & Giyaur, P.C. are ready to assist...
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  38 Hits
38 Hits
APR
01
0

New Guidance Regarding SBA PPP Loans

The US Department of Treasury has released new guidance regarding SBA loans to be made under the Payroll Protection Program. Some critical points clarified by the Treasury guidance include: PPP loan applications will be submitted directly to SBA-certified lenders, who can begin accepting applications as of April 3, 2020 (April 10th for independent ...
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  163 Hits
163 Hits
MAR
26
0

COVID-19 Employment Law Q&As

​ Q.   As a New York State employer, what paid sick leave or family leave laws are currently applicable to my business? ​A.  New York State employers are currently/will shortly be subject to: The Families First Coronavirus Response Act (federal law passed in response to COVID-19 crisis) New York State Paid Family Leave law (passed in...
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  172 Hits
172 Hits
MAR
24
0

GOV. CUOMO, DOH COMMISSIONER ORDER FACILITIES TO INCREASE BED AVAILABILITY FOR COVID-19 PATIENTS

Governor Andrew M. Cuomo and NYS Department of Health Commissioner Howard A. Zucker have ordered all medical facilities located in New York State— i.e. hospitals, ambulatory surgery centers, office-based surgery practices, and diagnostic & treatment centers—to take certain measures aimed at increasing bed capacity for COVID-19 patients. An offi...
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  199 Hits
199 Hits
MAR
18
0

CONGRESS AND HHS ANNOUNCE SIGNIFICANT EXPANSIONS TO MEDICARE TELEHEALTH COVERAGE IN RESPONSE TO CORONAVIRUS

Congress recently passed the Coronavirus Preparedness and Response Supplemental Appropriations Act, which the President signed into law. In an effort to encourage social distancing and increase access to care, the law significantly expands Medicare coverage for telehealth services. Specifically, Medicare will now cover nearly all telehealth service...
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  128 Hits
128 Hits
MAR
17
0

CORONAVIRUS EMERGENCY MEASURES: WAIVER OF STATE LICENSURE REQUIREMENTS, OTHER POLICIES GOING INTO EFFECT

  Federal and state governments are racing to implement emergency measures designed at containing and treating COVID-19. One such measure is the waiver of in-state licensure requirements for providers licensed in another state or jurisdiction. Presently, New York and New Jersey have not implemented such a measure, but approximately ten other s...
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  129 Hits
129 Hits
MAR
17
0

Telemedicine and COVID-19: Medicare to Reimburse Practitioners Treating Patients at Home

To encourage patients to seek medical attention from their homes rather than visiting a hospital or doctor's office ,  the Center for Medicaid & Medicare Services (CMS) will start reimburs ing  physicians and non-physician practitioners for "virtual check-ins" -- brief, virtual services with your established provider where the communi...
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  199 Hits
199 Hits
MAR
17
0

Laboratory Testing and Billing for COVID-19

Lab s performing diagnostic tests for the 2019-Novel Coronavirus ( COVID-19 ) have new HCPCS and CPT c odes for  bill ing and track ing new cases of the virus . T he Center for Medicaid and Medicare Services (CMS) has  updated the ir  standardized coding system , which Medicare and other health insurers use to submit claims for servi...
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  309 Hits
309 Hits
NOV
06
0

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 demand a wide range of documents and information pe...
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  478 Hits
478 Hits
AUG
21
0

Important Client Alert - OptumRx Provider Manual Update

IMPORTANT CLIENT ALERT The latest edition of OptumRx (ORX) Provider Manual (2019 4 th Edition) contains significant new provisions pertaining to maintenance of records by pharmacies.We expect that, in connection with desktop audits, ORX may start demanding documentation additional to that routinely reviewed in the past and may potentially decline t...
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  2080 Hits
2080 Hits
JUL
22
0

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 insurance plan. The Firm, on behalf of the prov...
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  725 Hits
725 Hits
APR
19
0

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 PSAOs, including PharmacyFirst (formerly, Third Party Station). GER is thought to be the commercial plan equivalent...
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  1130 Hits
1130 Hits
APR
10
0

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 bring a unique perspective to health law and healthcare-related issues.  As part of his tenure, Mr. Sauchik wi...
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  852 Hits
852 Hits
APR
03
0

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 and staff at the largest summit of specialty pharmacy senior executives, key decision makers and industry leaders. Visit us at Booth No. 722 or schedule a meeting with us by filling out the...
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  999 Hits
999 Hits
JAN
18
0

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 under review. Providers should take immediate action to avoid the prospect of serious sanctions, including but...
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  1101 Hits
1101 Hits
NOV
02
0

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 SUPPORT Act is available here . The SUPPORT Act will have a far-reaching impact on all healthcare providers and establish ma...
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  1466 Hits
1466 Hits
OCT
24
0

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 having a different perspective on what has taken place or what can be done to remedy the situation.  Whe...
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  1443 Hits
1443 Hits
OCT
16
0

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, his relative, and the pharmacist co-owner conspired to conceal cash income of pharmacies and did not report...
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  1578 Hits
1578 Hits
OCT
16
0

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 found can be subject to adjustments of thousands of dollars. Suspected misconduct has recently led to refer...
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  1267 Hits
1267 Hits