Billing & Reimbursement

Two landmark cases fraught with False Claim Act (“FCA”) allegations of fraudulent billing for prescription drugs against food and pharmacy chains are making their way from the Seventh Circuit to

Continue Reading Is it Really Fraud? The Supreme Court Will Decide

The federal No Surprises Act and interim final rules implementing the Act went into effect on January 1, 2022. Part I is aimed at reducing “surprise bills” to patients in

Continue Reading Surprise: Long Term Care Providers Are Not Exempt from The No Surprises Act’s Good Faith Estimate Requirement for Uninsured and Self-Pay Patients

The federal No Surprises Act is now in effect, and it is changing how medical practices, ambulatory surgery centers, and hospitals interact with patients and health insurers.  See our initial
Continue Reading The No Surprises Act is Here: How do Practices Comply? (Part I)

This post is a courtesy of Fox Rothschild attorney William H. Maruca, Esq., and was first published as an Alert on Fox’s website.

A bipartisan bill introduced this summer
Continue Reading Proposed Amendments to False Claims Act Would Tilt the Playing Field

Medical record requests by payors are commonplace for health care providers. Typically, these requests are received by a front desk employee who responds to the inquiry in short order.  Yet,
Continue Reading THE ABC’S OF THE S.I.U.: What Providers Need to Know

Fellow Fox Rothschild LLP attorneys Margaret J. Davino, Salvatore J. Russo and Nawa A. Lodin generously contributed this post.

On March 17, 2020, the Centers for Medicare & Medicaid
Continue Reading Medicare and OCR Relax Telehealth Rules Under Medicare and HIPAA

The New Jersey Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act (the “Law”), New Jersey’s “surprise” medical billing law, went into effect on August 30, 2018.  Among other things,
Continue Reading Time for New Jersey Medical Practices to Update Certain Patient Disclosures and Comply with the Surprise Medical Billing Law