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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 →

Tags : Nicholson & Eastin , white collar criminal defense

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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The HRSA COVID-19 Uninsured Program (UIP) has recently announced it will stop accepting claims for reimbursement due to the program’s lack of sufficient funds. This unexpected announcement has caused significant concern and confusion for businesses operating in this space, as it has historically been one of the primary and most reliable payors. As background, the Read more →

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The No Surprise Act (“NSA”) went into effect January 1, 2022, and impacts billing, and in particular balance billing, for emergency services as well as certain non-emergency services.  Generally speaking, a patient cannot be balance billed for emergency services.  Instead, the patient is only responsible for in-network cost share.  The NSA specifies how the insurers Read more →

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As part of its fight against fraud, waste and abuse, CMS contracted with supplemental medical review contractors to perform and/or provide support for a variety of tasks, including performing audits.  As part of their responsibilities, these contractors perform audits to identify overpayments.  Among the many projects being worked by these contractors, is a current review Read more →

Tags : Medicare Audit