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In the highly regulated field of healthcare, an experienced healthcare law attorney can make all the difference. A healthcare lawyer understands the healthcare industry, and is knowledgeable with relevant health laws, regulatory compliance and the issues facing healthcare professionals with healthcare regulation.
Legal and regulatory pitfalls can present themselves on a regular basis. Our healthcare attorneys at Weiss Zarett Brofman Sonnenklar & Levy, P.C., in New Hyde Park provide a wide range of legal services and support to healthcare organizations in New York and beyond.
Healthcare laws encompass a wide range of state and federal laws, regulations and protocols that medical professionals must comply with, conform to and understand to provide medical care and protect public health. These can range from vague, technical minutia to vast ethical guidelines. Businesses serving the healthcare industry often need guidance and support when navigating the regulation of healthcare and dealing with government agencies in order to be effective in their work.
At Weiss Zarett Brofman Sonnenklar & Levy, P.C., our goal is to serve you in a vast spectrum of healthcare law concerns. We work with major regional healthcare providers, pharmaceutical companies, smaller clinics, and private practices. Healthcare regulatory compliance and protocols often present difficult and complex legal challenges, but our healthcare lawyers have the knowledge, experience and skills to help guide you through legal issues.
Our dedicated team provides a significant breadth of experience that covers the full range of healthcare law concerns. We frequently help our clients in matters such as:
Our team of healthcare attorneys work to assess your legal challenges, help you identify your legal goals and provide efficient and effective solutions to the very complicated legal issues that arise within the healthcare industry.
Medical practitioners, from surgeons, cardiologists, ophthalmologists, psychiatrists, psychologists, nurse practitioners and dentists to laboratories and surgery centers, are experts in medical matters. Legal issues are much different, and straightforward resolutions aren’t always possible.
However, our firm takes pride in the knowledge our healthcare attorneys possess. We can answer your questions. Here, our healthcare lawyers answer some of the more frequently asked questions. For answers to your specific questions, we encourage you to schedule an initial consultation appointment.
Unannounced investigations from insurance companies and or law enforcement are stressful and require delicate handling. First, providers and their staff must obtain the identification and contact information of all investigators present, as well as their badge numbers, if applicable. Next, it is important to verify the identity of the investigators or law enforcement agents; this is critical for numerous reasons, including but not limited to protecting Protected Health Information.
Once verified, you may inform the investigators of your legal representation and provide the counsel’s contact information. The final step will be for the staff and or the client to immediately contact the law firm. The law firm will contact the investigators/agents or prosecuting attorney and have all requests for documents or any questions directed to the law firm.
The key to avoiding insurance audits is documentation, documentation, documentation!!! You must be proactive about this and retain the services of a certified coder who will review your documentation and your coding, making sure the documentation supports the codes that you’re billing.
The first thing you should try to do is not panic – although easier said than done. A large percentage of OPMC investigations are closed at the preliminary phase and do not develop to the point of formal charges. Still, you must take the investigation very seriously, assemble all supporting materials and fully prepare for the interview. Sometimes, if the investigation involves clinical care, an outside expert review may be helpful to avoid formal charges. We can help to guide you through each step of the process in order to put your best foot forward and hopefully avoid protracted disciplinary proceedings.
The National Practitioner Data Bank is a clearinghouse of information regarding disciplinary actions taken against a physician. If the information posted with the data bank is not reportable under the NPDB rules and regulations, a dispute resolution process exists to challenge the report and try to have it reviewed or modified. That process includes first entering the report into dispute status, during which time the physician is required to attempt resolving the matter directly with the entity that made the inappropriate report in the first place. If that is outcome is not satisfactory, the next step would be to administratively contest the report with the NPDB through their dispute resolution process. In the alternative, physicians also have an opportunity to post what is called a subject statement, which is the physician’s perspective on what happened and will be available for all querying organizations to view alongside the report.
There are state and federal laws that are implicated by a summary suspension, including New York Public Health Law Sections 2801-b and 2801-c, which regulate to some limited extent the permissible bases which a hospital can rely upon to terminate, suspend or curtail medical staff privileges. These laws also afford an administrative review process before the New York State’s Public Health and Health Planning Council. Likewise, the federal healthcare Quality Improvement Act includes a variety of “due process” requirements applicable to the hospital hearing and review processes, which hospitals typically attempt to comply with through their medical staff bylaws in an attempt to gain qualified immunity from liability.
Being summarily suspended by a hospital is a potentially catastrophic event for any physician. In the past, we have been able, at times, to represent clients and accomplish a reversal or modification of the summary suspension through informal negotiations and persuasion with hospital counsel. Other times we have been able to assist the physician in the hearing process. We have found that typically, legal assistance is quite useful when it comes to compliance with procedural rules and processes at the hearing; and, more importantly, to assist the client in preparing to present as compelling a case as possible in hopes of having the suspension reversed. Interaction with medical experts sometimes plays a pivotal role in responding to a summary suspension. Moreover, legal assistance is needed to assist the client in minimizing the downstream consequences of a summary suspension when it comes to licensure and other practice-related issues, such as privileges at other hospitals and managed care participation.
MSOs can be an extremely valuable tool for physicians who struggle to balance the provision of medical care with the day-to-day responsibilities of running a business. MSOs provide real and appreciable benefits to busy practitioners, allowing them to provide better patient care unencumbered by the demands of micromanaging the business. The ability to provide a turn-key office for busy physicians and the diverse array of administrative services and equipment that physicians typically require present an opportunity for MSOs.
No matter what type of complicated healthcare legal issues your company might be facing, we will provide you with legal advice based on our extensive experience working with professionals in the healthcare industry. We understand the struggles your organization might be facing and do not back away from difficult or complex issues. Contact us at 516-627-7000 or send an email inquiry using this form.
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