As the healthcare industry continues to see unprecedented regulation, we work to keep our clients out of the headlines and in compliance with today's regulatory and statutory requirements, including the Federal Physician Self-Referral Law (the “Stark Law”), the Federal Anti-Kickback Statute, state “mini” Stark and Anti-kickback Statutes, as well as the Federal False Claims Act, and the Emergency Medical Treatment And Labor Act (“EMTALA”), among others.
Healthcare providers regularly engage in business arrangements that may implicate the fraud and abuse laws. BakerHostetler has experience in the breadth of fraud and abuse matters, from analyzing a potential new business arrangement to reviewing ongoing compliance and assisting clients with handling a self-disclosure or government investigations. We understand that our clients are facing increased pressures from various enforcement agencies and we help them navigate expectation of self-governance in the increasingly regulated healthcare environment. Our clients have included hospitals and health systems, physician groups, laboratories, imaging centers and post-acute providers, such as home health agencies and DME suppliers.
Compliance programs
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 the fraud and abuse laws. Should a potential violation arise, we have found that a comprehensive, tailored compliance program can be persuasive in avoiding enforcement proceedings or receiving less severe penalties.
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 refining 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 comprehensive compliance programs. Our attorneys, several of whom include former U.S. Department of Justice healthcare prosecutors, have a first-hand 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 routinely conduct internal audits and address internal compliance issues, assist in voluntary disclosure of overpayments and respond to government inquiries and investigations. Our team’s knowledge 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.