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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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  114 Hits
114 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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  589 Hits
589 Hits
OCT
16
0

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 by 2020 if no change is made.  The appeals process, as of now, takes at least three to four years, duri...
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  654 Hits
654 Hits
SEP
23
0

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. Department of Justice has approved the proposed Cigna-Express Scripts merger, clearing a significant obstacle to Cigna's acquisition of...
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  771 Hits
771 Hits
AUG
18
0

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 practices. Over a decade later, private practice is still thriving in the industry.  As patient volume ...
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  1137 Hits
1137 Hits