The firm handles health care, health care regulatory and reimbursement, compliance, transactions, administrative and health care litigation matters. It represents the full range of providers, suppliers, managed care companies, pharmaceutical companies, pharmacy benefit managers, clinical laboratories, dialysis facilities, health systems, hospitals, teaching facilities, rural providers, FQHS, long term care providers, CCRCs, home health and hospice providers, ambulatory surgery centers, urgent care centers, physicians, physician organizations, dme, prosthetics, orthotics and supplies companies and others from initial formation, licensure, Medicare/Medicaid participation, change of ownership, to operations and compliance. It handles HIPAA, telehealth, EMTALA, value based purchasing, biotechnology, medical research and clinical trials, contracting, joint ventures, investigations and audits, and day to day regulatory compliance including but not limited to Stark and state and federal fraud and abuse anti-kickback, and False Claims Act compliance. It handles peer review and credentialing matters, medical staff disputes and reporting and serves as an independent hearing officer. It handles disaster relief and emergency preparedness matters. It advices on clinical integration, ACO, and other managed care participation.
The firm provides compliance counseling, training to staff and the officers and directors and other key personnel, drafts compliance plans, policies and procedures, conducts annual compliance reviews, provides advice and guidance to the compliance officer and HIPAA compliance officer, provides legal assistance in internal and external audits, provides legal assistance in licensure, survey and CHOW matters, seeks advisory opinions, guides its clients through voluntary disclosures, and repayment matters including extrapolation and data mining, on a state and federal level. It provides advice and guidance on The Ethics in Patient Referrals Act (Stark law) fraud and abuse anti-kickback laws, False Claims Act, HIPAA and EMTALA as well as other laws. It provides guidance regarding corporate integrity agreement, compliance and reporting and can also serve as an Independent Review Organization.
Government Investigations and Audits
The firm defends providers, suppliers, billing and managed care companies in government investigations and audits from the outset of the investigation or audit through the administrative or legal process, settlement, trial, and, if necessary, appeal. It handles government subpoenas, and CIDs, as well as qui tam and other complex litigation. It has handled matters before MACS, government audit contractors, ZPIC auditors, OIG, AUSAs, CMS, DEA and others.