Washington, D.C.

Health Care Compliance

In health care matters we advise a diverse cross-section of health care providers, private equity firms, and bankers. We counsel health care entities, and those who work with health care entities, in matters involving compliance with fraud-and-abuse laws, Medicare reassignment and other payment rules, telemedicine, e-health, HIPAA and other privacy laws, and health care data-breach response. We also advise clients in health care transactional matters, including mergers and acquisitions, formation of joint ventures, contractual arrangements, credit facilities. In addition to drafting and negotiating agreements, we perform due diligence for purchasers, investors, and lenders.

Regulatory Compliance

We represent clients in matters that involve compliance with federal and state fraud-and-abuse laws, including the Anti-Kickback statute, the Stark law, and the False Claims Act. We structure and restructure health care entities and joint ventures to comply with fraud-and-abuse laws.

Whether you need quick advice to avoid a single potentially improper payment, or in-depth investigation into the reguatory requriements of a complex business relationship, we can help you stay on the right side of a complicated, sometimes byzantine regulatory scheme.

HIPAA

We represent health care providers, and non-health care entities that provide services to health care providers (business associates), in HIPAA compliance. We guide responses to data breaches and improper disclosures of protected health information (PHI), advising clients on the necessity, nature, and scope of legally required notifications. We also assist clients with all other aspects of data breaches, from pre-breach assessments to post-breach investigations and litigation.

Civil Investigations

We represent clients in civil investigations of health care entities and management companies in disputes with government and commercial payors over reimbursement and fraud-and-abuse issues. We conduct internal investigations and guide clients in settlements with the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS), and we negotiate corporate integrity agreements. We also represent health care providers in payment disputes with Medicare and other third-party payors.

Corporate Health Care Transactions

Our attorneys have represented clients in a wide range of corporate transactions. We have advised management companies, private equity firms, and physicians in the formation, sale, and acquisition of management companies, physician practice-management companies, physician joint ventures, ambulatory surgical centers, health imaging providers, and urgent-care centers. We have also advised physicians in the sale of their practices to hospitals and management companies, management companies and hospitals in the acquisition of physician practices, and bankers regarding credit facilities.

Compliance Training

We advise clients in the creation of health care regulatory and HIPAA compliance plans, working with company executives to tailor compliance programs to fit each company's specific needs. We conduct training in compliance issues for executives and employees, both to educate them regarding legal requirements, and to ensure they understand their obligations under the company's compliance program, including how to recognize and combat fraud and abuse in company arrangements. We also provide training concerning HIPAA compliance issues to health care providers and commercial entities that provide services to health care providers, known as business associates.

Clients

We provide guidance to a wide variety of health care entities, including health care management companies, hospitals and health systems, physician and dental-practice management companies, large physician practices, lithotripsy providers, diagnostic-imaging companies, ambulatory surgery centers, endoscopy centers, vision service providers, ambulance companies, pharmacy networks, institutional pharmacies, pharmaceutical companies, disease management companies, assisted living facilities, substance-abuse treatment providers, skilled nursing facilities, medical-device manufacturers, e-health and telemedicine providers, and home-health agencies. We also advise private equity firms, banks, and other lenders.

Common Health Care Matters

  • Structuring of physician joint ventures to comply with the federal anti-kickback statute and the Stark law
  • Creation and implementation of fraud-and-abuse compliance programs
  • Creation and implementation of HIPAA compliance programs
  • Advice to purchasers, investors, and lenders on target companies' compliance with health care laws
  • Contracts for the provision of health care services
  • Review and drafting of health care representations, warranties, and covenants in purchase agreements and credit agreements
  • Advice concerning compliance with fraud-and-abuse laws regarding contracting with health care entities
  • Negotiation of settlements and corporate-integrity agreements with the Office of the Inspector General of the Department of Health and Human Services (OIG)
  • Internal investigations
  • Guidance in voluntary disclosures to the OIG
  • Procurement of advisory opinions from the OIG