ACO Formation & Contracting
Healthcare Regulatory Laws
Anti-Kickback and Self-Referral
The Florida Healthcare Law Firm regularly counsels clients on compliance with Federal and State Anti-Kickback statutes and provides in-depth guidance and analysis to healthcare providers on issues arising out of federal self-referral laws. Whether you require a brief explanation or a full-blown analysis and legal opinion, we will assist you in determining the most appropriate and effective manner in which to proceed.
Fee splitting is a common issue faced by providers in compensation situations, particularly in the presence of percentage-based fee arrangements. Violations of fee splitting statutes can create serious issues for all parties involved. The Florida Healthcare Law Firm can help to prevent you from becoming a victim.
Fraud and Abuse
The Florida Healthcare Law Firm is a reliable resource for navigating you around the world of increasingly complex and ever-changing fraud and abuse laws. We structure and document transactions and design policies and procedures for compliance with the fraud and abuse rules and counsel clients on how to properly unwind transactions and ventures. Some of the things we can do include:
- Structuring complex business arrangements;
- Conducting internal investigations to determine whether violations exist or have existed and to assist clients with self-disclosures to the government, if necessary;
- Performing healthcare fraud and abuse due diligence reviews; and
- Advising manufacturers and vendors on compliance with group purchasing organization safe harbors as well as financial relationships with physicians.
Physicians & Medical Practices
Perhaps no other group of professionals are as regulated by state and federal law as physicians. Even space and equipment rental arrangements are regulated. We know the complexity of laws like Anti-Kickback, Stark, Fraud and Abuse, Fee Splitting, EMTALA and antitrust and routinely advise physicians on matters such as hospital based contracting, medical group formation, employment contracts, compensation models, lease arrangements, ambulatory surgery center development, hospital call arrangements, merging, buying or selling medical practices and shareholder issues.
Our lawyers have significant experience drafting and interpreting contracts between healthcare businesses and professionals, including physician recruitment agreements, physician employment agreements, non-compete agreements, and exclusive provider agreements. We also have extensive experience with corporate founders, shareholders and operating agreements, buy-ins, compensation arrangements, practice sales and purchases.
Medical Staffs & Hospital Based Practices
We provide counsel for medical staffs based on knowledge and expertise in areas like medical staff bylaws, fair hearings, on call arrangements, conflicts of interest, disruptive physician policies, antitrust and EMTALA. In this era of growing financial relationships between physicians and hospital systems, it is exceptionally important for medical staffs to be independently represented and the interests of physician members to be protected.
The Florida Healthcare Law Firm routinely assists clients in reviewing, negotiating and advising on hospital recruitment and retention arrangements, including development of policies and procedures, counseling, drafting and negotiating final documents.
PAs, NPs and Nurses
We assist clients with the complex patient information privacy issues and technical security-related issues involved with the Health Insurance Portability and Accountability Act (HIPAA). Protecting patient data and deterring unauthorized access, use or disclosure of PHI is critical to prevent yourself from running afoul of the regulations. Be prepared with HIPAA Privacy and HIPAA Security Policies and Procedures which will stand up against such scrutiny. Make sure all of your business associate agreements are up-to-date and that you are not vulnerable to being assessed fees or, worse, that you will be put under a Corporate Integrity Agreement by the Office of Inspector General. We provide what you need, including detailed privacy and security forms, to maintain compliance with the intricate and demanding burdens of HIPAA.
Some services we have provided in the past involve on-site HIPAA education, training to boards of trustees, management, medical staffs and other personnel, policy and procedure assessment and development, business associate audits, minimum necessary assessments and HIPAA security audits. From analysis, to creation of policies and procedures, to implementation, to monitoring, to enforcement, to revision, we handle it all so that you don’t have to “roll the dice.”