We represent individuals and businesses in all types of state and federal health care regulatory compliance, including hospitals and clinics, behavioral health providers, licensed health care professionals, senior living providers and more.
With our extensive knowledge of state and federal regulations, much of which was learned while serving as government lawyers or administration officials, our health care team helps clients understand their responsibilities and manage risk in dealing with regulatory and compliance issues. We understand that your goal is always to be able to continue to operate your business with as little external impact as possible, and our experience and relationships with members at all levels of government and in regulatory agencies.
- Physician groups
- Behavioral health providers
- Hospitals and health care systems
- Home health care organizations and systems
- Senior living providers
- Trade associations
- Pharmacies and specialty pharmacies
- Dentists and specialists
- State and federal privacy laws, including data breaches
- Public and private payer reimbursement issues
- Fraud, waste and abuse
- Anti-kickback and Stark
- State licensing and enforcement
- Credentialing, privileging and peer review processes
- The purchase or sale of a medical or dental practice or business
- General corporate governance, management, and employment issues
- Represented a large specialty provider group in connection with its acquisition of a complementary provider group.
- Served as regulatory counsel for a behavioral health care provider in connection with its acquisition by a private equity sponsor.
- Conducted internal investigations for a large specialty provider group regarding potential billing and coding issues, reviewing and revising internal policies and procedures to ensure compliance.
- Negotiated with numerous health insurers to ensure that providers are receiving the statutorily and contractually correct reimbursement.
- Challenged a six figure overpayment demand from a health insurer, demonstrating that the extrapolation method used was fundamentally flawed, which resulted in the insurer withdrawing the overpayment demand in its entirety.