Regulatory/Compliance

Our health care team works with health care providers and health care businesses to ensure operational and regulatory compliance with state licensure and accreditation requirements, Medicare/Medicaid certification, fraud and abuse laws and other state and federal health care regulations. We offer complete corporate compliance legal services, including assisting in developing a corporate compliance program, training boards, senior management, employees and physicians, drafting policies, providing updates to regulations, obtaining interpretations from regulators, and performing compliance assessments for specified risk areas.

We have extensive experience and working relationships with state and federal regulators and Medicare Administrative Contractors (MACs) in seeking guidance on compliance questions, and regularly assist clients with internal regulatory investigations, implementation of corrective action plans and self-reporting overpayments, as appropriate. We also are involved in preparing self-disclosures and negotiating settlements on our clients’ behalf when an issue of noncompliance surfaces.

Areas of regulatory counsel and compliance that our team handles include:

  • Federal and state fraud and abuse laws
  • HIPAA/HITECH and other state privacy laws
  • Licensure, accreditation and certification
  • Medicare and Medicaid reimbursement
  • Section 340b
  • Clinical Research
  • EMTALA

We have extensive experience assisting health care professionals in licensing, certification and accreditation matters. We have advised clients through all stages of the licensing process and have successfully assisted clients in appeals of licensure denial. In addition, we advise our clients on compliance with Medicare Conditions of Participation and Conditions for Coverage.  We assist our clients with accreditation surveys, drafting any resulting corrective action plans and possible termination appeals. We have regularly represented clients before state licensing boards, The Joint Commission and federal agencies, such as the Centers for Medicare and Medicaid Services (CMS).  In addition, we defend health care professionals against allegations regarding professional conduct or personal matters, such as substance abuse or pending criminal charges, which could result in the loss or suspension of a medical license.

Our attorneys also represent health care providers in state and regulatory proceedings, and provide guidance on applicable state and federal requirements necessary to operate. We work with clients on licensure, certification and accreditation matters that arise in connection with various business arrangements, including applying for exceptions when necessary. We also assist providers with compliance and reimbursement matters in connection with ensuring proper licensure, certification and accreditation. 

Close