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15 Oct 2013, 6:00 am by Daniel E. Cummins
Anyone wishing to review a copy of this decision may contact the Pennsylvania Instant Case Service of the Pennsylvania Law Weekly at 1-800-276-7427 and pay a small fee for a copy. [read post]
15 Oct 2013, 6:00 am by Daniel E. Cummins
Anyone wishing to review a copy of this decision may contact the Pennsylvania Instant Case Service of the Pennsylvania Law Weekly at 1-800-276-7427 and pay a small fee for a copy. [read post]
31 Jul 2015, 11:56 am by Kevin S. Little
The statute makes it illegal to file claims for: Services not provided as presented (upcoding); False claims (services not provided); Services of a physician where the physician: a. was not licensed; b. obtained a license by misrepresentation; c. was not certified as represented. [read post]
25 Nov 2013, 6:41 am by Brian Hall
Sedgwick Claims Management Services, Inc. that had upheld Michigan workers’ compensation claimants’ rights to file federal RICO claims against their employers, their employers’ third party administrators and physicians who had conducted independent medical examinations on the theory that the defendants had conspired to unlawfully deny or terminate their workers’ compensation benefits. [read post]
20 Jun 2012, 8:49 pm by Administrator
If the reviewing physician determined the covered service to be medically necessary, the Illinois statute required the HMO to provide the covered service. [read post]
16 Mar 2014, 7:10 pm by Jacek Stramski
” The Hospital pointed to Florida courts’ recognition that “the ongoing duty to review and evaluate medical staff at issue in this case is part of the delivery of medical services to the public” O’Shea v. [read post]
6 Sep 2011, 1:48 am by Ben Vernia
VPA, Inc., affirmed a Michigan district court’s dismissal of a qui tam suit brought by a radiologist and his wife against the radiology service that contracted with them to read x-rays. [read post]
7 Oct 2015, 12:22 pm by Frankl & Kominsky, P.A.
After reviewing the CT scan, a physician determined the hydrocephalus was worsening and contacted Miami Children about having her transferred. [read post]
11 May 2016, 5:30 am by Kori Shafer-Stack
Any medical decision that modifies or denies a medical treatment request must be made by a reviewing physician, and the services must be within that physician’s scope of practice. [read post]
29 Aug 2017, 5:57 pm by Jon Gelman
R. 2:11–3(e)(1)(E).UNIVERSITY PHYSICIANS ASSOCIATES, Petitioner–Appellant, v.TRANSPORT DRIVERS, INC., Respondent–RespondentSuperior Court of New Jersey, Appellate Division. [read post]
11 May 2009, 6:40 pm
She also alleged that a physician referral service the insurer utilized was biased, given it generated large revenues from its reviews, and usually recommended in favor of the employer. [read post]
8 Nov 2011, 10:50 am by Michael H. Cohen
Nor may they contract with a physician to have the physician provide medical services, either as an employee or an independent contractor. [read post]