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23 Feb 2014, 6:36 am
An additional condition of the settlement requires EndoGastric to enter into a Corporate Integrity Agreement, a plan to implement reviews and procedures intended to prevent similar incidents, with the Department of Health and Human Services (HHS) Officer of Inspector General. [read post]
13 Feb 2014, 1:15 pm
The doctors who performed these procedures were part of a physician group called Cumberland Clinic that had an exclusive contract with Saint Joseph Hospital since 2008 to provide cardiology services. [read post]
7 Feb 2013, 12:07 am
Partner, Inc. v. [read post]
12 Jul 2018, 12:00 pm
As you review your documentation, try and imagine how it would appear to an outside reviewer. [read post]
14 Jun 2022, 6:01 am
” The agreement “provides for an annual review of its financial arrangements for compliance with the Anti-Kickback Statute and the Stark Law by an Independent Review Organization. [read post]
15 Mar 2021, 6:33 pm
Firstar Fin., Inc., 409 F.3d 286, 295-296 (6th Cir. 2005) In Calvert, the Sixth Circuit said that, while there is nothing inherently objectionable about a plan administrator using a file review of a claimant’s medical evidence, a plan administrator’s decision to conduct a file review, instead of a physical examination, is a “factor to consider in [the court’s] overall assessment of whether [plan administrator] acted in an arbitrary and capricious… [read post]
15 Mar 2021, 6:33 pm
Firstar Fin., Inc., 409 F.3d 286, 295-296 (6th Cir. 2005) In Calvert, the Sixth Circuit said that, while there is nothing inherently objectionable about a plan administrator using a file review of a claimant’s medical evidence, a plan administrator’s decision to conduct a file review, instead of a physical examination, is a “factor to consider in [the court’s] overall assessment of whether [plan administrator] acted in an arbitrary and capricious… [read post]
6 May 2016, 12:30 pm
Comment k itself refers to drugs, “many of which ... cannot be legally sold except to physicians, or under the prescription of a physician. [read post]
2 Jan 2010, 7:06 am
Wal-Mart Stores, Inc., 2009 WL 1688474 (E.D. [read post]
1 Nov 2022, 2:01 pm
On November 1, 2022, that office announced that Modernizing Medicine, Inc. [read post]
14 Feb 2008, 12:26 pm
The medical opinions rendered are those of the examining physician and based upon his/her clinical assessment and review of medical records.This description, however, is directly at odds with the allegations of the complaint, which states that "boilerplate medical evaluation reports" are used. [read post]
13 Dec 2011, 3:24 am
Plaintiff requested administrative review of the denial of benefits on July 11, 2009. [read post]
2 Apr 2019, 4:24 pm
Background In October 2015, a physician employed by Southern Illinois University and SIU Physicians & Surgeons, Inc. [read post]
7 Mar 2019, 8:04 am
June Medical Services, LLC v. [read post]
29 Mar 2011, 9:41 am
ESKATON PROPERTIES, INC. [read post]
5 Oct 2022, 4:11 am
First Coast Service Options, Inc. [read post]
1 Dec 2010, 7:08 am
According to my friends at Marsh USA Inc. [read post]
21 Aug 2010, 11:51 am
The guidelines further recommend that claimants review all medical reports to ensure their accuracy. [read post]
5 Nov 2015, 6:00 am
Mylan Pharmaceuticals Inc. v. [read post]
12 Oct 2009, 9:12 pm
RateMDs, Inc. [read post]
