Healthcare Transactional and Compliance Advice

As one of the most highly regulated industries in the country, providers in the health care industry face unique legal and regulatory challenges.  In addition to our healthcare litigation servicesour health care attorneys provide service to all types of health care providers, focusing its representation on non-institutional providers of health care services, including:

  • Physicians and Medical groups
  • Allied Health Professionals
  • IPA’s    
  • Hospices
  • Laboratories – Clinical and Anatomical
  • Physician Owned Laboratories
  • Home Health Agencies
  • Ambulance Suppliers
  • Durable Medical Equipment Suppliers
  • Diagnostic Testing Facilities
  • Ambulatory Surgery Centers

Our healthcare attorneys provide comprehensive legal counsel covering all aspects of a provider’s business or practice, from ongoing operational issues to licensing and certification, regulatory compliance or mergers and acquisitions.  Examples are:

Medical Groups   

  • Professional Corporation/Partnership Formation
  • Buy-Sell Arrangements
  • Ownership Succession
  • Employment and Independent Contractor Agreements
  • Management Services Agreements
  • Impaired or Disruptive Physicians and Fair Hearing Procedures
  • Recruitment, Hiring and Termination of Physicians
  • Purchase or Sale of Practice
  • Billing and Collection Practices
  • HIPAA and State Privacy Laws
  • Windup and Dissolution
  • Shareholder Disputes
  •  Exclusive Contracts

IPA’s    

  • Entity Formation
  • Strategic Alliances
  • Managed Care Contracting
  • Clinical Integration
  • Antitrust Analysis / Messenger Models
  • Management Services Agreements
  • Fair Hearing Procedures
  • Credentialing           

Individual Physicians    

  • Employment and Independent Contractor Agreements
  • Buy-Sell Agreements
  • Physician Deselection   
  • Provider Enrollment          

Laboratories     

  • Suspension or Revocation of CLIA and/or State Licensure
  • State Survey, Certification, Accreditation or Licensing Issues
  • Response to Surveys and Statements of Deficiencies
  • Compliance Plans
  • Physician Owned Laboratories
  • Medical Director Agreements   
  • Purchase or Sale

Hospices    

  • Survey, Licensing and Certification Issues
  • Appeal of Payment Denials Based on Medical Necessity
  • Appeal of Payment Denials Based on Conditions of Participation
  • Compliance Plans

Regulatory Compliance   

  • Fraud and Abuse Analysis
  • Stark and Anti-Kickback Analysis
  • Compliance Plans and Guidance             
  • Defense of Qui Tam Actions
  • Defense of Government Investigations
  • Voluntary Disclosures
  • Provider Enrollment
  • Credentialing

Reimbursement and Audit    

  • Audit of Billing and Collection Practices
  • Audit of Compliance Programs
  • Managed Care Contracting
  • Medicare, Medi-Cal or Private Payor Audits
  • Administrative Appeals of Overpayment Audits
  • Medicare and Medi-Cal Reimbursement Analysis
  • MAC & RAC Audits