Capabilities
Senior Living, Long-Term Care

Healthcare Regulatory and Public Policy

Our practice focuses on the full range of healthcare professionals and providers and suppliers of healthcare services, as well as new entrants into the health care market who are driving innovation in health information technology and mobile health. Our clients range from startups to regional operators to global enterprises as well as health-focused professional and trade associations. The breadth of experience among our team allows us to bring varied and creative perspectives to address our clients’ needs. Key areas of our practice include regulatory compliance and internal investigations and disclosure; fraud and abuse and government investigations; reimbursement policy and challenges, business transformation, issues stemming from changes of ownership and control, and privacy and data protection.

We specialize in conducting regulatory due diligence reviews and risk assessments of healthcare companies and we often act as healthcare regulatory counsel to owners, operators, managers, investors, buyers, sellers and lenders in the healthcare industry. Our understanding of the senior living, long-term care, and other healthcare facility industry, along with our fraud and abuse and regulatory expertise, enables us to efficiently identify risk areas, and potential liabilities, such as Medicare successor liability, associated with a company’s contractual arrangements and operations. 

Many of our attorneys and policy advisors have previous government agency and association experience working on Medicare home health, hospice, skilled nursing facility, and durable medical equipment coverage and payment policy. We regularly monitor and advise clients on legislative, regulatory, and policy initiatives in these areas and other senior care issues. This industry-specific knowledge helps our clients keep up-to-date with new requirements and policies, and prepare for future changes in the regulatory landscape and associated challenges.

Representative healthcare regulatory and public policy matters below

  • Fortune 500 companies on the federal and state regulatory implications of various high-value mergers and acquisitions of long-term care facilities.
  • Skilled nursing facilities in several government fraud investigations and related False Claims Act allegations.
  • Various hospitals, large multi-specialty physician practices, smaller physician groups, individual physicians, multi-state physician practices, and medical societies and professional associations on federal anti-kickback and selfreferral (Stark) laws, state fraud and abuse laws, and patient privacy and confidentiality.
  • Various healthcare clients in the designing, implementing, and providing ongoing advice with respect to compliance programs for hundreds of providers, including teaching and community hospitals, large regional hospital and healthcare systems, professional practices, specialty clinics, and a variety of similar entities.
  • Multiple clients in assessing the need to make voluntary disclosure where potential problems have been identified, and assisting in the development and presentation of such disclosures to both Centers for Medicare and Medicaid Services and the Office of Inspector General.
  • An institutional provider in various in-depth and confidential compliance audits to help strengthen existing compliance programs and ensure that they meet the “effectiveness” standard necessary to provide protection for the institutional provider in case of an investigation or enforcement action, and defended companies in investigations and litigation regarding allegations of fraud and abuse laws.
  • Filed statutory injunction challenging HHS Secretary’s authority to suspend federal Medicare payments.
Overview

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