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DOH Investigation Regarding Alleged Improper Balance Billing Closed With a Finding of No Probable Cause

Posted on Firm News, Health Care Law News May 13, 2022 by Erin Ferber

With the implementation of the No Surprise Act on January 1, 2022, patients, insurers, and regulatory authorities have begun taking a closer look at the billing practices of healthcare providers, especially for out-of-network providers. Due to decreasing reimbursement rates, increased oversight, and challenging hurtles to get credentialed, more providers are choosing to operate as out-of-network Read more →

Understanding the Implications of the Federal Anti-Kickback Statute and its Florida Counterpart, the Patient Brokering Act

Posted on Health Care Law News May 13, 2022 by Erin Ferber

The Federal Anti-Kickback statute (“AKS”) is a criminal statute that prohibits the exchange (or offer to exchange), anything of value, in an effort to induce (or reward) the referral of business reimbursable by Medicaid, Medicare, or any other federal health care program. Conviction for a single violation under the Federal Anti-Kickback Statute may result in Read more →

U.S. DOJ Announces $150 Million Nationwide Coordinated Law Enforcement Action to Combat COVID-19 Health Care Fraud

Posted on Fraud Investigation, Health Care Law News April 26, 2022 by Parker Eastin

On Wednesday, April 20, 2022, the U.S. Department of Justice (DOJ) announced, a nationwide coordinated law enforcement action to combat health-care-related COVID-19 fraud. Specifically, the DOJ revealed criminal charges – including health care fraud, illegal kickbacks, money laundering, wire fraud, theft of government property, making false statements, and aggravated identity theft – against 21 defendants Read more →

Establishing Medical Necessity as DOJ Ramps-Up COVID-19 Related Enforcement

Posted on Health Care Law News, Medicare Reimbursement April 20, 2022 by Erin Ferber

The Families First Coronavirus Response Act (“FFCRA”), which was enacted in March of 2020, requires insurers to provide benefits without imposing any cost-sharing in connection with certain items and services related to the testing and treatment for COVID-19.  Curiously, the legislation is silent as to the concept that is well-known in the healthcare industry today Read more →

License Investigation Against Allegedly Impaired APRN Closed with a Finding of No Probable Cause

Posted on Firm News, Professional Licensure Investigations April 11, 2022 by Parker Eastin

The Firm successfully defended an Advanced Practice Registered Nurse (APRN/CRNA) against allegations that the APRN was impaired on the job, was diverting anesthesia drugs for the APRN’s own use, and was altering drug counts to cover up the diversion. The Firm investigated the allegations at issue and prepared a rebuttal statement that highlighted evidence that Read more →