Current trends in the health care industry have created a business environment in which hospitals, physicians, health care companies, and executives face increased regulations and heightened government scrutiny. These conditions have motivated the industry to emphasize compliance issues in order to avoid government investigations and the consequences of those investigations.
Zuckerman Spaeder's health care attorneys help clients adapt their business practices to the complexity of regulations and to achieve the best possible outcome when investigations occur. We team medical industry experts with seasoned litigation defense attorneys to apply their practical experience and acute insight to help health care companies and providers operate most effectively and productively within the context of the statutes regulating them.
REGULATORY PRACTICE
Zuckerman Spaeder guides clients through self-audits and formulates and implements compliance programs to address these regulations. We handl licensing and reimbursement matters relating to Medicare, Medicaid, and all types of insurance. Health care companies and providers are subject to rules on patient care, confidentiality, privacy, medical records, self-referral, anti-kickback, Stark, and HIPAA regulations. If there is a federal or state investigation, Zuckerman Spaeder represents clients in disciplinary, licensing, and other hearings, and against allegations of fraud and abuse.
HEALTH CARE FRAUD AND ABUSE
Clients may face a number of allegations about their billing and accountin practices. Also, Medicare reimbursement claims may lead to qui tam and false claims allegations. In counseling clients in these and other scenarios (with regard to Stark or anti-kickback violations, for example), Zuckerman Spaeder strives to avoid litigation through exhaustive internal investigations and reviews of all records. When we are called in after an investigation has begun, we seek to overturn or minimize potential penalties, and we defend in litigation.
HOSPITALS, PHYSICIANS, AND MEDICAL STAFF ISSUES
The regulations that apply to hospitals are particularly complex and evolving, including those related to research involving human subjects, emergency room screening and treatment practices, living wills, brain deat statutes and medical record releases and retentions. Zuckerman Spaeder proactively advises clients on compliance with the regulation of these matters. We also represent hospitals in agency investigations and litigatio of these and more direct issues, such as health care fraud and insurance reimbursement.
Physicians face similar concerns in their individual practices and as a result may need to appear before regulatory and disciplinary bodies. Our health care attorneys represent doctors in these proceedings and in general business matters. Zuckerman Spaeder works with both hospitals and physicians on medical staff issues, including physician credentialing, medical staff bylaws and peer review matters, corrective action proceedings, and many aspects of the physician-hospital relationship such as physician privileges and disciplinary actions.
MEDICARE AND MEDICAID
Our attorneys advise clients on compliance with intricate Medicare and Medicaid regulations. When necessary, we appear on their behalf before CMS and state health care agencies and defend against health care fraud allegations, through criminal and civil investigations, pertaining to Medicare and Medicaid.
LITIGATION
When clients do not have wide-ranging compliance programs in place, or when they are investigated despite having these programs, Zuckerman Spaeder's health care attorneys collaborate with the firm's white collar criminal defense attorneys to mount a comprehensive, vigorous defense at trial or on appeal. These litigators' exceptional skill and perception reassure health care companies and providers that, to the greatest extent possible, their businesses and reputations will avoid undue damage as a result of litigation.
The firm recently obtained dismissal during trial of a civil false claims act allegation arising out of home health care in Chattanooga, Tennessee.