Healthcare is part of our firm's DNA. We add real value to our clients' business through our in-depth understanding of the key legal, regulatory and practice-related issues.

FOCUS ON
HEALTHCARE

Whether representing large specialty pharmacies or small community stores, we bring our knowledge of the industry and client-centered approach to help our clients succeed in the face of the toughest challenges

PHARMACY
EXPERTS

Experienced, dedicated and well-tested litigation attorneys who enjoy the challenges of the courtroom

DEDICATED
LITIGATORS

When you need attorneys who know and understand your business, not just the letter of the law

PROTECTING
YOUR
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Today, hospitals and Article 28 facilities are playing an increasingly more prominent role in the process of health care delivery.  Recent federal and state legislative initiatives have accelerated the shift in the delivery model from small private practices to large, integrated networks, major hospitals, diagnostic and treatment centers and ambulatory surgery centers.  With the ever increasing prominence, hospitals and Article 28 facilities now face a heightened regulatory scrutiny, need to comply with a slew of new and ever changing laws and regulations, and are involved in more complex business transactions than ever before.  To help our clients successfully overcome these new challenges, we offer the following services to our hospital and Article 28 clients:

  • Corporate representation (including antitrust counseling) in connection with transactions, including mergers, acquisitions, joint ventures, and divestitures
  • Regulatory counseling on Fraud and Abuse, Stark Law, and state regulatory compliance issues in transactions and other physician- integration arrangements
  • Synthesizing tax-exempt law requirements with Fraud and Abuse rules in hospital-physician arrangements and joint ventures
  • Seeking Advisory Opinions from federal regulatory agencies in appropriate cases
  • Labor and employment issues
  • HIPAA compliance
  • Medicare and Medicaid (and other government health program) compliance activities, including internal investigations of potential noncompliance, responding to government inquiries and investigations, advise in connection with voluntary disclosures, negotiating corporate integrity agreements (CIAs)
  • EMTALA compliance
  • Establishing and implementing corporate compliance programs for hospital and ancillary providers within the health system
  • Addressing medical staff matters, including fair hearing requirements and designing state-of-the-art medical staff bylaws

We have successfully represented Article 28 facilities in a wide variety of business transactions, including establishment, expansion, mergers and acquisitions and joint-venture deals.  We routinely counsel Article 28 facilities on the issues of regulatory compliance, Medicaid, Medicare and third party reimbursements, contracting and response to investigations and audits.  We defend Article 28 facilities in proceedings involving allegations of fraud and abuse. We also represent Independent Diagnostic Testing Facilities (IDTFs) in all legal matters, including establishment, compliance counseling, reimbursement, audits and investigations and contracting with other providers.

 

Roche's Test Strips Lawsuit Targets Wholesalers,

On March 28, 2017, Roche Diagnostics Corp. and Roche Diabetes Care, Inc. filed a lawsuit in the U.S. District Court for the Southern District of Indiana, entitled Roche Diagnostics Corp. et al. v. Binson's Hospital Supplies, Inc., et al., ​Docket No. 17-cv-0949 (LJM)(DML). The Indianapolis-based subsidiaries of the . . .

In News and Updates

TOWARDS INCREASED PBM TRANSPARENCY

Is Increased PBM Transparency on the Way?

Newly proposed Federal legislation would increase PBM transparency regarding aggregate rebates and "spread pricing".An oft-controversial issue, independent pharmacy associations have long lobbied for greater disclosure of the rebates that PBMs receive from drug companies, which . . .

In News and Updates

INSURANCE PLAN NOT PERMITTED TO “CROSS-PLAN”

A Federal District Court in Minneapolis has issued a highly favorable decision for physicians and healthcare providers on the limits of an insurance plan's ability to recoup.  Specifically, the court ruled that insurers can only recoup against providers from the same health plan that the alleged overpayment was issued . . .

In News and Updates

MDRXLaw 2017 Q1 Newsletter - Focus on PBM

We are pleased to announce the publication of our 2017 First Quarter Newsletter devoted to the issues facing pharmacies in connection with PBM audits.

In News and Updates

MFCU Takes Recoupment Actions Against Providers

Calling the attention of every New York Medicaid provider reimbursing its billing/collection agents on a percentage basis, the New York State Medicaid Fraud Control Unit (MFCU) has recently sent out recoupment letters demanding repayments of Medicaid funds paid to billing companies under fee-splitting . . .

In News and Updates

MEDICARE APPEALS BACKLOG MUST BE CLEARED,

In a groundbreaking decision addressing one of the most pressing issues currently faced by Medicare providers, the U.S. District Court for the District of Columbia ordered CMS to clear the lengthy backlog of Medicare appeals at the administrative law judge (ALJ) level.

Under the Medicare Act, CMS must provide an ALJ . . .

In News and Updates

PROTECTING ACCESS TO PHI

As providers continue to rely on software vendors to maintain protected health information ("PHI"), a well-drafted business associate agreement ("BAA") becomes increasingly important. The BAA will set forth the obligations between providers and business associates such as software vendors with respect to the PHI.

Software . . .

In Healthcare Publications

A GUIDE TO NY & NJ INTEGRATED CARE FACILITIES

New regulations governing integrated care are affording health care providers and facility operators a cost-effective opportunity to expand the range of treatment services they offer. As is true in the early stages of any significant regulatory shift, it is vital for providers and operators to stay aware of the complex regulatory developments that affect integrated care facilities.

New York and New Jersey recently adopted facility models . . .

In News and Updates

AGENCY PROFILE: MEDICARE FRAUD STRIKE FORCE

This is the first article in an educational series to appear on the MDRXLaw Blog, profiling various regulatory and law enforcement agencies and entities relevant to health care providers. Given the number of agencies and entities having jurisdiction over health care providers, the individual role played by each can often be unclear. This post will profile the Medicare Fraud Strike Force, an interagency law enforcement collaboration.

In . . .

In News and Updates

Unprecedented National Health Care Fraud

NEWS BRIEF: Unprecedented National Health Care Fraud Crackdown; 301 Individuals Charged; $900 Million in False Billing Alleged

The joint DOJ-HHS Medicare Fraud Strike Force and twenty-three state Medicaid Fraud Control Units executed an unprecedented nationwide sweep earlier this week, announced as the largest health care fraud . . .

In News and Updates

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