Regulatory and Corporate Compliance
Health care and related service providers are subject to a myriad of highly intricate federal and state laws and regulations. Our Health Care Practice Group brings decades of experience counseling its health care clients and assisting them in their efforts to comply with these laws and regulations. We offer advice that is designed to simultaneously assure compliance and minimize interference with the delivery of patient care and services.
We advise clients on matters involving fraud and abuse, governmental and payor audits and investigations, billing, reimbursement, compliance plans, survey, licensure, certification, managed care, health care delivery, health information privacy, anti-trust and tax. Our attorneys counsel health care organizations in identifying and managing the risks of non-compliance and assist in the implementation of measures designed to assure compliance.
We encourage our clients to carefully evaluate routine and complex regulatory matters, with the ultimate goal of proactive risk management. In that regard, we have designated and developed compliance initiatives and programs for a wide range of health care clients. Our attorneys understand the unique needs of nonprofit health care clients and the high levels of accountability to which nonprofit entities may be subject.
Our attorneys work extensively with clients on health care delivery and patient care issues, including advance directives, guardianships, medical ethics, treatment, admission, discharge and involuntary commitment. Given the labor-intensive nature of health care and human services delivery, our labor and employment attorneys regularly counsel health care clients on employment, collective bargaining, discrimination, employee benefits and immigration matters.
The rules governing health care operations continue to evolve as new laws are passed, new regulations are promulgated and new guidance is issued. We actively monitor the regulatory initiatives of state and federal governments and provide strategic advice to clients on how to comply while achieving their business objectives.
Our firm provides counsel in many regulatory areas, including:
- Stark/Anti-Kickback/False Claims
- Medicare/Medicaid/Third Party Payor Reimbursement
- Defense of Governmental and Payor Audits and Investigations
- Appeals of Payment Denials and Overpayment Determinations
- Fraud and Abuse
- Voluntary Self-Disclosures
- Corporate Compliance Plans and Programs
- Survey, Licensure and Certification
- Certificate of Need
- Conditions of Participation
- Regulatory Due Diligence
- Health Care Delivery
- Advance Directives/Guardianships
- Medical Ethics
- Managed Care Contracts
- Insurance Regulation
- HIPAA and Health Information
- Medical Staff and Credentialing
- National Practitioner Data Bank
- Peer Review
- Tax