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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 →

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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 →

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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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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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