Foley & Mansfield attorneys provide a full range of legal services to clients in the health care sector. We represent physicians, health care professionals, home health agencies and other health care entities in a variety of areas relating to health law and regulations - ranging from whistleblower actions, to contractual, licensing and employment related matters, including the sale or acquisition of medical practices.
Our areas of service include:
Health Care Start-Ups and Business Operations
When launching a new business, getting off to a good start is critical to the success of any practice. We are here to assist with a variety of issues affecting start-up health care ventures, including regulatory compliance , privacy laws and intellection property, general operational matters, and National Institute of Health (NIH) grant applications.
We also have experience with entities that conduct business nation-wide, including representing a national physical therapy management company in connection with all aspects of their business model and litigation, and a national mail-in optical company in all operational matters including e-commerce, regulatory and licensing compliance, and contracting.
Expansion and Dissolution of Health Care Entities
We have litigated cases involving break-ups of surgical practices and associated business issues and shareholder disputes. We also have experience in litigation resulting from a practice break-up and the buy out of a departing member. For example, we represented sellers in litigation arising from the sale of a home health agency, and represented a buyer in the acquisition of a surgical center and certificate-of-need (“CON”) transfer.
Contract and Employment Issues
Through collaboration with Foley & Mansfield's experienced employment attorneys, we are fully equipped to handle all employment and non-compete matters pertaining to licensed healthcare professionals. We have represented physicians in connection with employment contract negotiations and release from non-compete agreements, and have experience in matters involving confidential patient lists and solicitation of patients by departing physicians. As an example, we negotiated the elimination of a series of covenants not to compete, thus allowing a client to continue its relationships with a major medical insurance company. We also successfully represented a physician in connection with obtaining a release from a non-compete agreement with a large hospital system.
Regulatory Compliance and Professional Licensing
We frequently represent physicians and other health care professionals in licensing reinstatement and disciplinary actions with numerous medical boards, including the Michigan Board of Medicine and Board of Physical Therapy. As an example, we represented a physician in a licensing matter before the Board of Medicine, which successfully resulted in the dismissal of the administrative complaint with no licensing action taken by the Board. We have also been involved with DEA de-registration and re-registration litigation, and National Practitioner Data Bank (“NPDB”) responses and exceptions.
We also advise clients on the scope and ramifications of federal and state health laws, including HIPAA and other privacy regulations, the Michigan Public Health Code, the Wellstone-Domenici Parity Act and even copyright/trademark matters.
Audit and Reimbursement Matters
We counsel clients on coding, billing, insurance and Medicare/Medicaid issues, including Medicare opt-outs and Advanced Beneficiary Notice (“ABN”) requirements. For example, we have handled a dispute relating to alleged Medicare billing errors and the indemnity provision in an agreement for the sale of a billing practice. We also work with health care providers on Medicare/Medicaid de-participation, re-participation, exclusion and reinstatement.
Fraud and Abuse/Self-Referrals
Violations of self-referral laws such as Stark and federal/state Anti-Kickback statutes can result in hefty fines and even criminal penalties. We regularly counsel clients on how these laws may impact proposed transactions, partnership arrangements and other remuneration issues, including but not limited to physicians, chiropractors and ambulance companies.
This practice area includes proceedings related to prescription fraud and abuse, excessive billing, upcoding, and overbilling for medical procedures and diagnostic tests.
We have represented physicians against major metropolitan hospitals for denial of fair hearing rights, denial of Medical Staff Bylaws rights, tortious interference, and other associated privileging/credentialing claims. For example, we successfully represented a physician in a peer review proceeding against a large community hospital, and a nurse in a disciplinary action proceeding involving a public hospital. We also have represented physicians with respect to National Practitioner Data Bank (“NPDB”) responses and exceptions.
Foley & Mansfield's experienced trial attorneys are well prepared to assist in matters arising out of or related to the services above.
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