Compliance and Corporate Governance Oversight

Overview

As the healthcare industry continues to face unprecedented regulation, we work to keep our clients out of the headlines and in compliance with today's regulatory and statutory requirements, including federal and state anti-kickback statutes, Stark Law, False Claims Act and U.S. export control laws, among others. Our national team works with clients to establish proactive compliance and auditing programs to place them in the best position to prevent, identify and deter violations of these laws. Should a potential violation arise, we have found that an "effective" preexisting compliance program can be persuasive in avoiding enforcement proceedings or receiving less severe penalties.

Our Approach

We routinely advise clients, their boards, management, compliance committees and officers on the changing needs and requirements of providers and others in the healthcare industry. Our experience includes establishing or improving corporate compliance programs tailored to a specific organization’s needs, while at the same time meeting or exceeding official guidance published by state and federal authorities concerning effective compliance programs. Our attorneys have a firsthand understanding of the government’s analysis of an effective compliance program and work to ensure that our clients’ compliance programs and initiatives are designed as such.

We also conduct internal audits and address internal compliance issues, assist in voluntary disclosure of overpayments and respond to government investigations. Our healthcare practice strengths in reimbursement, fraud and abuse compliance and corporate governance inform our approach to assessing compliance risks. We see beyond the horizon to help clients minimize the legal, economic and reputation risks posed by compliance and governance oversight matters.

Select Experience

  • Represented academic medical centers in internal compliance audits of Medicare billings and related self-disclosure of various departments, including obstetrics, surgery, internal medicine, orthopedics, family practice, neurology, dermatology and cardiology.
  • Represented hospitals in internal investigations of admissions to inpatient rehabilitation unit.
  • Represented various healthcare provider entities in development and implementation of corporate compliance plans, including plan design, risk assessments, internal reviews, self-audits, voluntary disclosures and repayments to governmental and private health programs.
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Experience

  • Represented academic medical centers in internal compliance audits of Medicare billings and related self-disclosure of various departments, including obstetrics, surgery, internal medicine, orthopedics, family practice, neurology, dermatology and cardiology.
  • Represented hospitals in internal investigations of admissions to inpatient rehabilitation unit.
  • Represented various healthcare provider entities in development and implementation of corporate compliance plans, including plan design, risk assessments, internal reviews, self-audits, voluntary disclosures and repayments to governmental and private health programs.
  • Assisted in internal and external investigations and regulatory compliance activities related to reimbursement, including evaluation and management coding, supervision and coverage requirements related to ancillary services and mid-level providers and Stark and anti-kickback laws.
  • Provided general Stark Law and fraud and abuse advice to hospitals and other healthcare providers regarding structuring compliant relationships with physicians and other referral sources, including contractual relationships, such as leases and employment and medical director agreements, including addressing the unique nature of such relationships in an academic medical center environment.
  • Provided general fraud and abuse advice to healthcare providers regarding structuring compliant relationships with beneficiaries relating to various issues, including the provision of discount cards, complementary local transportation, conducting health fairs and deductible and copayment issues.

Recognition

  • Recognized as one of the top law firms for client service, we were named to the 2018 BTI Client Service 30 for the fourth consecutive year.

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