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Physicians and Physician Groups

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The medical profession continues to change rapidly.  Physicians, non-physician practitioners, and provider-related businesses are faced with legal, financial, regulatory, and cultural changes.  The consolidation of the health care industry, driven in large part by higher technology and compliance costs and efforts to drive down the cost to federal programs, presents unique challenges to physicians. The relationships among providers, patients, and payers are shifting to accommodate these changes. We have broad experience in counseling in establishing relationships in integrated settings.

At the same time, providers are faced with a variety of audits, refund demands, compliance reviews, and other enforcement activities of regulatory agencies and third party payers.  We regularly assist providers in responding to and defending such actions, as well as providing assistance in establishing compliance training and plans to avoid pitfalls in many practice areas governed by payer and regulatory authorities.

Services

  • Stark Act compliance
  • Anti-Kickback Statute compliance
  • False claims matters
  • Physician practice formation
  • Provider network formation
  • Physician-hospital affiliation strategies
  • Mergers and acquisitions among providers
  • Ambulatory surgery center start-ups and growth issues
  • Joint ventures and ancillary businesses
  • Peer review hearings, staff privileges, and state licensure issues
  • Management of health care records
  • Managed care and accountable care contracting
  • Clinical integration among providers
  • EMR issues and health IT management
  • Telemedicine and technology issues
  • Payer relations, audits, and appeals
  • Billing, coding, and coverage issues
  • Intellectual Property protection, copyright, and patent prosecution
  • Federal and state government relations
  • Antitrust issues in contracting and business activities
  • Litigation, mediation, and arbitration
  • Human resources issues
  • Termination of care issues
  • HIPAA compliance and breaches