Recent Publications
To the dismay of most self-employed physicians today, both the practice of medicine and the “business” of medicine have become so intertwined that it has become impossible to differentiate between the two. Unfortunately, physicians who choose to resist this trend, or worse ignore it, too often find themselves mired in unfavorable contractual relationships that can lead to lower revenue for the practice.
On the close of the 2019 session, the NYS Legislature passed sweeping changes to the State’s discrimination laws that will make it easier for employees and outside contractors who interact with those employees, to bring and sustain discrimination claims.
In today’s healthcare climate, many providers have been subject to an audit by Centers for Medicare & Medicaid Services (CMS) whereby CMS (through one of its contractors) requests a sample of records and subsequently determines that the documentation does not substantiate the codes billed. Accordingly, CMS requests that money be “repaid” in connection with the services previously provided and paid. In some instances, CMS limits the overpayment request to those documents it has actually reviewed, while in other instances CMS takes the amount involved and corresponding error rate and “extrapolates” that amount to extend over a larger universe of claims spanning several years, resulting in a significantly increased overpayment demand which can be millions of dollars.
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