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Recent Update on the Law of Co-pay Accumulators and Patient …

WEBIn removing the 2021 rule, the court reinstated the 2020 NBPP rule, which allowed insurers to only utilize co-pay accumulators to exclude manufacturer assistance …

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URL: https://www.frierlevitt.com/articles/recent-update-on-the-law-of-co-pay-accumulators-and-patient-cost-sharing-limits-beware/

As More Specialty Medications Hit the Market, State Legislatures …

WEBState legislatures are taking steps to limit high copayment or percentage cost sharing for specialty medications that are on the market. These steps are a

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Healthcare Orgs. & Entities: What You Need to Know About …

WEBTo qualify for Nonprofit status, the corporation must be formed to benefit (i) the public, (ii) a specific group of individuals, or (iii) the membership of the Non-Profit …

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CMS Proposed Revisions to Prescription Drug Benefit Program …

WEBCMS has recently proposed revisions to the Medicare Advantage (MA) Program (Part C) and Prescription Drug Benefit Program (Part D) regulations that will

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Qui Tam Case Against Physicians and Hospital Advances on What …

WEBA U.S. District Judge found that two agreements between a set of doctors and a University of Pittsburgh Medical Center-owned hospital ran afoul of the Stark Law …

Category:  Medical Go Health

The Lower Costs, More Transparency Act and Potential Impact

WEBThe House of Representatives recently voted to pass a bill intended to deliver on those demands. The bill, entitled The Lower Costs, More Transparency Act …

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Healthcare Attorney Healthcare Law Firm Frier Levitt

WEBHealthcare Industry Experience. Frier Levitt’s attorneys have decades of experience creating, evaluating, and negotiating arrangements that comply with the …

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HHS Announces $5.1 Million Settlement for HIPAA Breach …

WEBOn January 15, 2021, the Department of Health and Human Services Office for Civil Rights (“OCR”) announced that Excellus Health Plan, Inc. has agreed to pay $5.1 million and to …

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Management Services Organizations (MSOs)

WEBAn MSO is a company that provides non-clinical services to medical practices, ambulatory care facilities or other healthcare providers. Services provided by an MSO may include …

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Healthcare Litigation Attorneys Frier Levitt

WEBHealthcare Litigation. Frier Levitt represents healthcare professionals in prosecuting and defending a wide range of litigation and arbitration matters on both an individual and …

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Physician Integration Models: CINs. MSOs. & Integrated Group …

WEBArguably the gold standard for physician integration, IGPs are entities (usually LLCs) consisting of multiple physicians (either single or multi-specialty) that …

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FTC Expands PBM Investigation to PBM-Owned Rebate …

WEBOn May 17 th, the FTC issued additional compulsory orders to Zinc Health Service, LLC (“ Zinc ”) and Ascent Health Services, LLC (“ Ascent ”) as part of its probe …

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SaveOnSP Program and Other Co-pay Maximizers Costing …

WEBSaveOnSP over-inflated patients’ co-pay amounts to the maximum (in JNJ’s complaint, JNJ referenced a statement provided by a SaveOnSP representative, “if the …

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Why OON Providers Need a Limited Power of Attorney from Patients

WEBMany OON providers utilize assignment of benefit forms so that a provider can be paid by an insurance company directly or the provider can dispute nonpayment …

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New Jersey Updates Employer Poster Display Requirements for …

WEBThe New Jersey Division on Civil Rights (DCR) amended its regulations governing the display of certain employment-related posters in the workplace relating to …

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Impact of the Supreme Court’s False Claims Act Decision on …

WEBThe two essential elements of an FCA violation are: (1) the falsity of the claim; and (2) the defendant’s knowledge of the claim’s falsity (i.e., the FCA’s “scienter” …

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A Deep Dive into the CMS Audit Appeals Process: A …

WEBA critical aspect of the CMS audit process is the recoupment procedure, wherein CMS may choose to recover the alleged overpayments by offsetting the …

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Selling Your Medical Practice to a Hospital

WEBHospitals induce physicians to sell their practice assets in exchange for a lump-sum purchase price, plus a salary that is 10% to more than 25% greater than what …

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Change Healthcare Announces It Is Ceasing Prescription Discount …

WEBIn early 2024, Change Healthcare announced that it would be winding down its prescription discount card lines of business and would cease acting as an …

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Telemedicine at Frier Levitt

WEBTelehealth and telemedicine are rapidly growing methods of providing patient care by way of electronic communication in lieu of direct face-to-face patient encounters. Healthcare …

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HHS Proposes Significant Modifications to the HIPAA Privacy Rule

WEBOn January 21, 2021, the U.S. Department of Health and Human Services (“HHS”) published proposed rules that would significantly modify existing On January 21, …

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Michigan Imposing Tighter Regulatory Controls on Compounding …

WEBOn April 24, 2014, the Michigan Senate Health Policy Committee held its first hearing on Senate Bills 704 and 904, a pair of proposed legislation which

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