Blog - Monthly archives: April 2022

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 →

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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 →

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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 →

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The Firm Secures AHCA Exemption for Convicted Felon

Posted on Firm News April 11, 2022 by Erin Ferber

After being told by other attorneys not to bother applying for an exemption to work at a healthcare facility regulated by the Agency for Health Care Administration, an Office Administrator came to Nicholson & Eastin for help.  Almost twenty years following a federal felony conviction, the Office Administrator was almost forced to resign her position Read more →

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Pharmacy Challenges Wrongful Enrollment Denial and Wins

Posted on Firm News April 11, 2022 by Erin Ferber

Successfully enrolling or recredentialing as a provider in an insurance network can be challenging regardless of whether you are seeking enrollment in a federal or state funded program, or with a commercial carrier.  In recent years, many insurance carriers have contracted with third-party’s to oversee the credentialing process although the insurers remain the determiner of Read more →

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