Our Insights

Author: Carolyn McKaige, Compliance Manager   In a pivotal ruling from the Eastern District of Pennsylvania, CVS Caremark finds itself in hot water, facing significant repercussions for allegedly manipulating prescription drug pricing. (See:  United States of America ex rel. Sarah Behnke v. CVS Caremark Corporation, No. 14‑cv-824 (E.D. Pa. June 25, 2025)  This high-stakes case, […]

Author: Sherrie Allen, Vice President of Clinical Services   Life Care Planning: Bringing Clarity to Life’s Toughest Moments When a catastrophic injury or chronic illness turns life upside down, navigating the future can feel overwhelming. That’s where Life Care Planning steps in—with compassion, clarity, and expert guidance. At Allan Koba, our Certified Life Care Planners […]

Author: Sherrie Allen, Vice President of Clinical Services   If medical records feel like a foreign language or opposing experts sound like they’re reciting Latin, you’re not alone. Legal Nurse Consultants (LNCs) are the missing link—registered nurses with legal savvy who decode healthcare data into actionable legal strategy.   Why Legal Teams and Insurance Carriers […]

Author: Sherrie Allen, Vice President of Clinical Services   🚨 The Case of the Unnecessary Transplant Picture this: A middle-aged woman with post-COVID cardiac complications. A shocking recommendation for a heart transplant buried in her records. A price tag of millions added to her Medicare Set-Aside (MSA). But here’s the twist: the suggestion came from […]

Author: Michelle Allan, Principal   In the dynamic world of governmental oversight, managing risks and reducing errors are crucial for ensuring compliance. Recently, these risks have become more pronounced in the Medicare Secondary Payer arena due to increased governmental scrutiny and new legal enforcement measures. Even minor typographical errors can lead to penalties and other […]

A message from Allan Koba Principal, Ciara Koba   Growing up, my oldest sister was the kind of environmentalist who made you side-eye her choices (lovingly, of course). Case in point: When she visited me in Pittsburgh years ago, she met with an engineer that built her a car that ran on used cooking oil […]