Proposed Rule for 2021 Medicare Fee Schedule Includes Changes to Telehealth Billing and Use of Evaluation and Management Codes

By: Seth A. Nadel, Esq. On August 3, 2020, the Centers for Medicare and Medicaid Services (“CMS”) issued its Proposed Rule for the 2021 Medicare Physician Fee Schedule (“Proposed Fee Schedule”). The Proposed Fee Schedule incorporates several proposals which could affect future physician billing, including changes to rules regarding use of Evaluation and Management (“E&M”) codes, […]

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2020 OIG COMPLIANCE WORK PLAN

By Mathew J. Levy, Esq., & Stacey Lipitz Marder, Esq. Investigations by Medicare and Medicaid are constantly on the rise. Each year, a Work Plan is published by the Office of the Inspector General (OIG) (which is updated monthly) showing the priorities and major initiatives that it intends to investigate during the fiscal year. The […]

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Out and Back: COVID-19 Paid Leave Changes in New York

By: Carla Hogan, Esq. & Toni-Ann M. Buono, Esq. In previous articles, we summarized the federal paid-leave laws and regulations under the Families First Coronavirus Response Act (“FFCRA”) and the New York State Paid Sick Leave for COVID-19, and the benefit interplay between the federal, state and New York City laws and regulations. As previously reported, under the New York State Paid Sick […]

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Preliminary Injunctive Relief and Medical Staff Privileging Disputes

By David A. Zarett, Esq. & Zoila Sanchez, JD, MPH (Legal Intern) Adverse action by a hospital against a physician’s medical-staff appointment or clinical privileges—such as summary suspension, termination or non-renewal—poses potentially catastrophic consequences to a physician’s practice and career. While most hospitals afford the physician internal “due process” hearing rights to challenge the adverse […]

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Impact of COVID-19 on Healthcare Providers Involved in Litigation

By: Toni-Ann M. Buono, Esq. As healthcare providers continue to focus their efforts on battling the COVID-19 pandemic, litigators across New York have welcomed once-thought unconventional modes of conducting depositions, hearings and oral arguments with open arms.  As the courts, for the most part, remain closed to all but court personnel, attorneys and clients alike […]

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Force Majeure and Business Interruption in the Age of COVID-19

By Michael D. Brofman, Esq. & Michael J. Spithogiannis, Esq. The onset of the COVID-19 pandemic and government’s response was immediate and stunning, but few had time to fully consider and comprehend the long-term effects on their businesses.  The rights and obligations of commercial tenants to pay rent amid the governmental restrictions, and whether an […]

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Third Department Reverses Award of MLMIC Demutualization Proceeds to Employer, Rules Employee-Policyholder is Legally Entitled to Disputed Funds

By Seth A. Nadel, Esq. As discussed in a prior article, on April 24, 2020, the Appellate Division, Fourth Department, in the case of Maple-Gate Anesthesiologists v. Nasrin, 182 A.D. 3d 984 (4th Dep’t 2020), unanimously affirmed a decis*ion of the Erie County Supreme Court that a physician-policyholder was entitled to the proceeds resulting from […]

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Understanding Private Equity Transactions in Healthcare

By Mathew J. Levy, Esq. & Stacey Lipitz Marder, Esq. Introduction When healthcare providers consider their options with respect to selling their practices, many providers are entertaining the idea of selling their practices to a private equity firm. While this may seem very enticing to many providers as the purchase price is often higher than […]

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Manslaughter Charges Affirmed Against Prescribing Physician For Patients’ Fatal Overdoses

By Jessica M. Seidman, Esq. In the current climate of heightened awareness of the dangers of opioid addiction–and enhanced enforcement by New York State Health Department’s Office of Professional Medical Conduct and the Drug Enforcement Administration–New York’s highest court, by majority decision, has recently affirmed the conviction of a physician on charges of manslaughter in […]

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