In a landmark decision for out-of-network healthcare providers, the Third Circuit recently held in a published opinion that an out-of-network provider’s direct claims against Aetna for breach of contract and ...
Previously, we posted an article describing the various stimulus options for healthcare providers and small businesses experiencing financial hardship as the result of COVID-19. In particular, the article articulated how ...
Firm Member Vincent N. Buttaci recently appeared on Essential Adaptations, a video podcast hosted by Dr. Jeff Frederick and Dr. John Guiliana of Podiatry Risk Group. Mr. Buttaci discussed the ...
As the landscape of providing care during the COVID-19 pandemic continues to evolve, our provider clients continue to request advice on the evolving local and federal legislation on telehealth so ...
It is no secret that due to COVID-19, most people—including our clients’ patients—are doing their best to stay home to do their part in flattening the curve. And even though ...
As the world navigates through these unprecedented times in trying to slow the spread of the COVID-19 virus, our provider clients are routinely asking, “What now?” On March 16, 2020, ...
On June 28, 2018, a federal judge in Texas held that the Centers for Medicare & Medicaid Services (“CMS”) was not permitted to recoup 7.6 million dollars in alleged Medicare ...
On May 16, 2018, the Third Circuit in American Orthopedic & Sports Medicine v. Independence Blue Cross Blue Shield held anti-assignment clauses in ERISA governed health insurance plans are generally ...
On September 11, 2015, in North Jersey Brain & Spine Center v. Aetna, Inc., the Third Circuit held in a precedential opinion that a patient’s assignment of benefits does not ...
The United States District for the District of New Jersey has certified as a class action a lawsuit brought on behalf of thousands of chiropractic physicians who were denied reimbursement ...
With significant changes in the medical field due to the passage of the Affordable Care Act, the current fee-for-service health care model is likely on its way out. However, though ...
Two doctors practicing in Secaucus and Hawthorne, New Jersey recently admitted that they accepted various bribes in exchange for test referrals. The bribery scheme was operated by Biodiagnostic Laboratory Services ...
The Einstein Healthcare Network has joined in with Banner Health in Phoenix, Wake Forest Baptist Medical Center in Winston-Salem and Mount Sinai Hospital in New York in lawsuits against administrators ...
A key feature of the Affordable Care Act (ACA), the loosening of Medicaid eligibility requirements, is aimed at making coverage available to the working poor whose wages are near the ...
In an effort to ease some of the medical profession’s trepidation concerning the Affordable Care Act (ACA), many proponents have pointed out that it is likely to bring a new ...
