Health Law
GC Peters Law, PLLC specialize in all areas of healthcare law. We guide our clients through the legal aspects of health care so that they can focus on their business and patient care. Our attorneys regularly work with providers’ existing counsel to provide the healthcare expertise required to advise healthcare clients. We have extensive experience representing providers in all areas of healthcare law, including, but not limited to:
Stark Law, Anti-Kickback Statute, Fraud & Abuse
GC Peters Law, PLLC structures healthcare entities and transactions to comply with the federal Stark law, federal Anti-Kickback Statute, and other federal and state health care authorities governing healthcare fraud and abuse and relationships between healthcare providers and other entities.
The Stark law, often referred to as the federal physician self-referral prohibition, governs the ability of physicians to refer certain types of Medicare and Medicaid services to entities with which the physician (or an immediate family member of the physician) has a financial relationship. Our firm has advised clients regarding the Stark law since its inception in 1995, and we regularly assist providers in analyzing whether Stark applies to a given situation and, if so, whether a Stark law exception is available for the arrangement and how to structure the arrangement to comply.
GC Peters Law, PLLC also has vast experience advising providers and evaluating relationships under the federal Anti-Kickback Statute (AKS), which generally prohibits healthcare providers from providing or receiving any kind of remuneration in return for the referral of Medicare, Medicaid or other federal healthcare program services. The AKS is a criminal statute and interpreted broadly, and a violation of the AKS has significant implications on health care entities.
In addition to the federal and state fraud and abuse laws discussed above, health care providers and other entities may be further restricted by federal or state billing rules (for example, Medicare and state anti-markup rules), requirements of private payors, Medicare and other payor conditions of participation or certification, certificates of need and notice requirements, among other applicable authorities.
Our team has over 30 years of experience structuring business operations, arrangements, contracts, policies and procedures to comply with federal and state fraud and abuse laws. Our team is prepared to guide your entity or transaction through these complex authorities.
Health Care Business Transactions
When structuring health care business transactions, entities must account for the rules, regulations, and other considerations specific to the healthcare industry. Our attorneys regularly assist health care providers and other entities in structuring business transactions to both meet their business goals and remain compliant with state and federal rules and regulations, including the Stark law, AKS and state self-referral, anti-kickback, fee-splitting, corporate practice of medicine and other relevant laws. Whether you are purchasing, selling, restructuring or forming a new entity or joint venture, our experienced health law attorneys can lead you through the process – from planning the structure and analyzing the regulatory implications, to drafting the required corporate and transactional documents.
Healthcare Regulatory & Compliance Law
In today’s regulatory environment, healthcare providers and other entities must remain compliant with the always changing rules and regulations facing the healthcare industry. While almost all of our practice areas involve regulatory compliance, a review of your entity’s compliance with applicable authorities or the implementation of an effective compliance program will mitigate risk for your health care entity. Compliance plans create a culture of compliance within your entity, provide security and demonstrate good faith in the event of a government or other third party investigation. Our healthcare regulatory and compliance attorneys have been structuring compliance plans for over 30 years, from assessing risk, to policy development, to implementation and maintenance of an effective compliance program. In addition to being a wise business decision in the current audit and regulatory landscape, compliance programs are increasingly required by state and federal laws for certain provider types, for example skilled nursing facilities. Our firm can help your health care business remain compliant and develop an effective compliance program that will meet the requirements of applicable laws and help your entity avoid audits and overpayment demands.
HIPAA, HITECH & Privacy Laws
Additionally, because HIPAA has been expanded to apply directly to business associates, our firm often represents vendors and other entities that provide support for the health care industry in understanding their HIPAA obligations and assist, for example, with the drafting of business associate agreements, as well as business associate subcontractor or “downstream business associate” agreements.
Our firm is also experienced in representing entities subject to complaints, investigations, or compliance reviews pursued by the Department of Health and Human Services’ Office of Civil Rights (OCR) or other state or federal agencies. We are also well-equipped to represent entities who have been selected either for a desk or onsite audit for the recently announced 2016 Phase 2 HIPAA Audit Program.
Other Practice Areas
In addition to the above practice areas, GC Peters Law, PLLC has significant experience with matters including:
- Licensing, Staff Privileges, and Credentialing
- Supply Chain and Purchasing
- General Healthcare Counsel
- Provider and Supplier Enrollment and Participation Matters
- Healthcare Litigation
- Certificates of Need
- Employment Issues
- Healthcare Billing and Reimbursement
- Healthcare Fraud
- Managed Care
- and substantially all other areas of health care law.