Shumaker Manufacturing

A Legal & Industry Review


Feds Shine a Light on Medicare Advantage Plans and Physicians Related to Risk Adjustment Practices

Although the sufficiency of medical records documentation supporting beneficiary diagnoses for Medicare Advantage (MA) risk adjustment has been on the OIG’s work plan since 2013, the Department of Justice has upped the ante with a 2016 physician criminal conviction and recent intervention in two qui tam cases related to MA risk adjustment. These initiatives allege that MA plans made false claims by submitting diagnoses for risk adjustment that were unsupported by medical documentation or medical condition and that both insurers and providers engaged in a variety of questionable practices.

Follow the link to read more of the Client Alert, “Feds Shine a Light on Medicare Advantage Plans and Physicians Related to Risk Adjustment Practices”, authored by partner Kelly A. Leahy and associate Rachel B. Goodman of Shumaker, Loop & Kendrick, LLP.


“Employee ‘No Poaching’ Agreements Meet the Antitrust Laws: Protection of Employees in the New Economy”

For centuries employers have maintained a strong interest in trying to protect their most valuable asset, their key employees, from solicitation by and loss to other employers, especially competitors. As a result, “no poaching” (i.e., “we agree to not solicit or hire each other’s employees”) agreements have become prevalent, not only in contracts between competitors, but also in many vendor/buyer agreements.  

Follow the link to read more of our Insights article, “Employee ‘No Poaching’ Agreements Meet the Antitrust Laws: Protection of Employees in the New Economy”, authored by partner Michael Briley of Shumaker, Loop & Kendrick, LLP’s Toledo office.

 


“The Uniform Voidable Transactions Act in a Nutshell”

The UVTA reflects an update to creditors’ rights law, and serves as a reminder that as transactions become more sophisticated, creditors, too, must be vigilant in protecting their rights. As transactions continue to expand beyond state and country lines, creditors of the parties involved must understand the consequences of such expansion. Creditors in all jurisdictions, especially those without the UVTA, must be increasingly aware of how a debtor can force a creditor to seek relief under the law of a pro-debtor location.

Follow the link to read more of our Insights article, “The Uniform Voidable Transactions Act in a Nutshell”, authored by Tampa partner David Slenn and Sarasota partner Mark Hildreth at Shumaker, Loop & Kendrick, LLP.

 


Revised Form I-9 is Now Available for Use

Providing personal identification has become both accepted and expected in many parts of our day to day lives. Whether boarding a plane, buying a home, purchasing an alcoholic beverage or entering a particular venue, we as consumers know that our identity will inevitably come into question at some point or another. When seeking employment, it comes as no surprise that the candidate must disclose private information regarding where they come from, who they are and their ability to legally perform work for the company. It is in the nature of our legislature for laws to change over time, therefore, highly important to stay current, such as periodically reviewing the updated documentation requirements for employment.

 Follow the link to read more of the Client Alert, “Revised Form I-9 is Now Available for Use,” authored by Maria Ramos partner at Shumaker, Loop & Kendrick, LLP.