ALL HEALTH CARE PROVIDERS FUNCTION IN AN EVER-CHANGING, COMPLEX AND HIGH-RISK REGULATORY ENVIRONMENT.
As regulators and legislators continue prioritizing enforcement actions against perceived provider fraud and abuse, government investigators continue to target providers such as health systems, hospitals, skilled nursing facilities, inpatient rehabilitation facilities, large multi-specialty physician groups, ambulatory surgery centers, laboratories, home health agencies, hospices and non-other provider entities, including pharmaceutical and medical device companies. Whistleblowers who may benefit from such actions also are incentivized to file cases. No health care organization is immune, no matter how effective its corporate responsibility program, so experienced legal counsel is crucial.
Areas of Focus
- Anti-Kickback Statute
- Compliance Audits
- Compliance Education & Training
- Excluded Providers
- False Claims Act
- Fraud & Abuse Issues
- Government Investigations
- Licensure & Accreditation
- Stark Law
- Survey & Certification
The Hall Render Advantage
Hall Render’s national compliance practice represents clients across the country and is composed of a large, diverse group of attorneys in all our offices. The compliance team provides counsel on the full spectrum of regulatory compliance matters, ranging from prevention and assessment to investigation defense and resolution. These matters include, but are not limited to, audits, voluntary refunds, self-disclosures, investigations and others as further described below.
Hall Render’s Fraud and Abuse attorneys represent providers across the health care industry to provide in-depth guidance and counsel with respect to issues arising under the federal Stark and Fraud and Abuse Laws. We assist health care providers on all aspects of:
- Fraud and Abuse/Antikickback/Stark;
- Hospital-Physician Alignment;
- Provider Financial Arrangements;
- Medical Group Strategy; and
- Physician-Owned Hospitals
Hall Render’s National Health Care Litigation practice has the experience to guide you from notice of a claim through successful resolution in government investigations, whistleblower fraud, retaliation lawsuits, reimbursement litigation and data breach allegations. These health care litigators and their colleagues bring a deep, nuanced and sophisticated understanding of health care to the dispute resolution process.
Hall Render’s Managed Care practice is not limited to negotiating contracts between payors and providers but rather fully encompasses all the legal and compliance issues that surround managed care. While Hall Render remains a primarily provider-focused firm, we assist many of our facility clients in building out Hospital Sponsored/Owned Plans. We have experience with Medicare, Medicaid, commercial (both fully insured and self-funded ERISA), ACA and Tricare plans. From privacy to special investigations, from building compliance programs to assisting with Corporate Integrity Agreements, our team of managed care compliance counsel is here to help both providers and provider-sponsored plans attain their goals in the most compliant way possible.
Hall Render’s Operations/Clinical service line provides counsel regarding a number of patient care and safety, governance, licensing and accreditation issues that arise in various health care settings. Our team members have experience and expertise with health systems, hospitals, rural health care providers, ambulatory surgical centers, dental practices, behavioral health entities, catholic health care, academic medical centers and post-acute care settings across the country. We advise on the clinical matters that impact health care providers and the industry.
Hall Render’s Post-Acute Care attorneys represent providers across the post-acute care spectrum including nursing homes, assisted living facilities, home health agencies and hospice programs. We assist post-acute care providers in all aspects of their business, including regulatory compliance, reimbursement, mergers and acquisitions, fraud and abuse, and labor and employment law. Our attorneys have also been very active in helping nursing homes implement compliance programs that are now mandated by federal regulations. We are especially skilled at responding to allegations of compliance imposed by State and Federal agencies. We routinely assist post-acute care providers in preparing and reviewing plans of correction and informal dispute resolutions for providers subject to adverse surveys. We also have vast experience in representing clients before the Department Appeals Board, State Medicaid agencies, state departments of health and Medicare contractors. We have also managed Corporate Integrity Agreements for post-acute care providers.
Hall Render’s Privacy & Security service line includes attorneys who represent health care providers, health plans, and entities that provide services for or on behalf of health care providers in privacy, security, and data breach matters as they arise under HIPAA, 42 CFR Part 2, and state law. From a compliance standpoint, the Privacy & Security Service Line offers legal services to assist clients with the development and review of privacy and security policies and procedures, privacy and security audits, breach assessment and notifications, OCR and Attorney General investigations, and analysis of uses, disclosures, retention and destruction of health information.
Hall Render’s Reimbursement service line provides counsel regarding regulatory compliance, reimbursement and payment practices. Our team members have experience and expertise with Medicare and Medicaid administrative appeals, Medicare/Medicaid compliance strategies and reimbursement analyses associated with federal and state law impacting payment from governmental payers. Our team provides counsel to a variety of different health care providers and can provide in-depth guidance and counsel to help clients developing strategies to ensure compliance with the Medicare and Medicaid programs.
If your organization is in need of compliance guidance and practical solutions, please contact us to get started.
Speaker Topics: Voluntary Disclosures; Corporate Compliance Programs; Internal and Government Investigations; Negotiating and Managing Corporate Integrity Agreements
Ritu Kaur Cooper is a shareholder in Hall Render’s health section. Ritu’s practice consists of representing health care providers such as hospitals and health systems in litigation, regulatory and compliance matters with particular focus on fraud and abuse, compliance and internal and government investigations, as well as voluntary disclosures. Ritu regularly works with legal and compliance departments to assist clients with the development of effective compliance programs consistent with OIG guidance. She drafts compliance policies and procedures, develops and provides compliance education and training from the Board level to employees to contracted physicians, drafts and negotiates agreements consistent with the fraud and abuse laws and assists clients with internal investigations and implementing appropriate corrective actions.
Speaker Topics: Government Investigations; Self-Disclosures; Corporate Compliance Programs; Negotiating and Managing Corporate Integrity Agreements
Katherine Kuchan, a Shareholder in the firm, provides legal counsel to clients in numerous states regarding regulatory and compliance matters, including advising clients on fraud and abuse matters coordinated through federal and state enforcement agencies, defending hospitals, physician practices and other providers involved in governmental investigations, coordinating internal investigations, advising corporate compliance officers and assisting with repayments to government health care programs through voluntary refunds and CMS and OIG self-disclosures. She actively works with hospitals and other health care entities on special regulatory matters including management of and compliance with Corporate Integrity Agreement requirements, survey and licensure and EMTALA.