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Federal and State Regulatory Compliance, including evaluating operational and compliance issues under the Stark Law, Federal Anti-Kickback Statute and the Emergency Medical Treatment and Labor Act (EMTALA), medical staff bylaws, conflicts of interest and disclosure laws under the Physician Sunshine Law, clinical trials and research issues, including IRB reviews and ongoing compliance with state and federal laws. We have experience advising providers delivering care in the acute and post-acute, long term care, rehabilitation, hospice, home health and independent living settings, including addressing issues involving physician integration and other models to address health care reform.
Reimbursement Issues, including extensive experience in third-party audits, OIG investigations, ZPIC and CERT reviews, RA and MAC coding and medical necessity audits, voluntary disclosures and government repayments, advice regarding free-standing vs. provider-based considerations, “incident to” considerations, bundled payments and other reimbursement issues.
Health Information Privacy and Security Compliance, including HIPAA and HITECH compliance, state privacy law compliance, required documentation of privacy and security practices, and breach analysis and notification as appropriate.
Tax and Tax Exempt Counseling, as to Federal and state income tax applicability, assessment of private inurement/public benefit issues, joint ventures between not-for-profit and for-profit entities, and overall tax-exempt status options; sales and use tax impact.