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  Ms. Giyaur’s wide-ranging transactional practice focuses on providing legal guidance on various corporate, organizational and operational matters as well as regulatory and compliance guidance for the health industry clients of Sauchik & Giyaur, P.C.   Ms. Giyaur counsels healthcare providers in compliance issues, including the... analysis of state and federal fee-splitting, anti-kickback and self-referral laws. She has drafted various Compliance Plans for Providers with respect to the Fraud and Abuse and the HIPAA regulations as well as various other regulations promulgated by state and federal agencies including the NYS Office of Medicaid Inspector General and the NYS Department of Health. Her experience also includes counseling clients on establishing, purchasing and selling pharmacies and medical/dental practices as well as ambulatory surgical and urgent care centers, dealing with a wide range of regulatory issues affecting medical and pharmacy practice in the State of New York including provider enrollment with the NYS Medicaid Program and Medicare, negotiation of a wide-variety of industry-specific health care agreements including employment, service and managed care contracts, providing guidance with fraud & abuse prevention and compliance, and counseling health care clients on operational issues.  Ms. Giyaur also represents physicians and pharmacies in audits proceedings and demands for repayment undertaken by managed care entities as well as Medicaid and Medicare. Ms. Giyaur has represented clients in professional disciplinary proceedings before the Office of Professional Discipline and the Office of Professional Medical Conduct, defended malpractice actions as co-counsel and in situations where there was no insurance or inadequate insurance, represented providers in insurance reimbursement matters with both private carriers as well as Medicaid and various managed care plans, represented providers in partnership and professional corporation dissolutions, and litigation involving the enforceability of restrictive covenants between professionals among other professional, corporate and partnership disputes.  Ms. Giyaur has represented various healthcare professionals in white-collar criminal investigations led by the NYS Office of Attorney General, the NYS Office of Medicaid Inspector General, the Drug Enforcement Administration as well as the US Attorney’s Office for the Southern and Eastern Districts of New York.Ms. Giyaur has also represented physical and occupational therapy providers among other non-physician healthcare clients with regard to licensure, real estate, corporate and transactional matters.   More
MAR
25
0

E-script Requirements Going Into Effect

Effective March 27, 2016, a new law will require New York State prescribers to issue prescriptions electronically directly to a pharmacy, with limited exceptions. The new law requires electronic prescribing for all types of medications (controlled substances and non-controlled substances) and for syringes and other medical devices dispensed at a ph...
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  3781 Hits
3781 Hits
JAN
07
0

Medicare Appeals - New Developments, Old Delays

Office of Medicare Hearings and Appeals (OMHA) recently created a new website to facilitate monitoring of ALJ appeals. Physicians, DME suppliers & other providers can now check on the status of filed Medicare reimbursement appeals, find useful documentation as well as other information pertinent to the appeal. OMHA also launched listserv websit...
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  4483 Hits
4483 Hits
NOV
24
0

MEANINGFUL USE AUDIT: HOW CAN A PRACTICE PREPARE?

While the stated goals of meaningful use compliance include terms such as empowerment, improvement and efficiency, for many participating physicians the possibility of a meaningful use audit just adds another level of anxiety to the already stressful and increasingly time-consuming burden of administrating a medical practice in the current regulato...
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  3813 Hits
3813 Hits
NOV
24
0

THE INDEPENDENT PHARMACY’S GUIDE TO SURVIVING A PBM AUDIT

Nothing is as critical to the economic health of an independent pharmacy as successfully resolving inevitable audits by Pharmacy Benefits Managers ("PBMs"). While the PBM concept originated as a measure to cut back on fraud, waste and abuse, the current role played by a PBM can often be perceived as antagonistic to the interests of independent phar...
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  5714 Hits
5714 Hits
OCT
06
0

NEW YORK PHYSICIANS COMPLIANCE PROGRAM MANDATE

The New York State Office of Medicaid Inspector General ("OMIG") has long required Medicaid providers to implement compliance programs as a condition of enrollment with Medicaid. However, now under Federal law, practitioners, regardless of the size of their practice, will have to develop a comprehensive compliance program. Under Section 6401 of the...
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  4368 Hits
4368 Hits