From health information privacy to fraud and abuse prevention, Hinshaw helps you stay within the lines.
Ask any executive, pharmacist or billing-department employee: health care is more highly regulated and scrutinized than virtually any industry. While most will agree that quality care, patient privacy, cost-efficiency and other standards are necessary, the complex web of health care laws and regulations can, at times confound even the most sophisticated health care companies.
The experienced regulatory lawyers of Hinshaw’s health care team do more than cut the red tape. We help providers, insurers and other parties to understand the many state and federal requirements that govern their operations and to establish effective processes and systems to ensure compliance. When disputes with regulators or law enforcement officials arise, our experienced litigators rise to the occasion, helping clients cooperate with audits and investigations and, when necessary, defend their interests in court.
From structuring strategic transactions, to advising on scope of practice, licensure requirements, patient care, billing, data privacy, documentation and other day-to-day business operations, we help clients minimize risk and exposure to audits, investigations or regulatory challenges. We have significant experience assessing fraud and abuse and self-referral concerns, and regularly represent clients who have been investigated by or received a complaint from state licensing boards.
Among other activities likely to trigger fraud and abuse and other compliance issues, we assist clients with:
- Anti-Kickback Statute, False Claims Act, and the Ethics in Patient Referral Act matters
- Billing practices
- Clinical research, and trials
- Collections and payment disputes
- Environmental matters
- HIPAA privacy and security, and state data privacy laws
- Joint venture agreements
- Licensure, accreditation, and certification
- Medicare/Medicaid reimbursements
- Pharmacy regulatory compliance
- Physician compensation and financial arrangements
- Professional responsibility/liability
- Provider enrollment
- Provider/physician relationships
We have a successful record representing the interests of insurers and health care providers in litigation. We recognize that, in some cases, the breadth of our representation can give rise to potential conflicts of interest. We take great care to ensure that no such conflicts exist before agreeing to an engagement and take full advantage of our experience to represent all clients to our utmost ability.