We provide support to clients in healthcare law. We advise on issues related to healthcare business operations, medical insurance recovery, and regulatory compliance.
Healthcare Business Operations
Selecting a business structure for your healthcare operation can be a complicated task. We help you understand the differences between entity types to adequately fit your company needs.
We advise on the appropriate structure of medical practices to meet legal guidelines set forth by statutory law and case law.
We help draft and review single member PLLC agreements , multi-member PLLC agreements, shareholder agreements, by-laws, and buy-sell agreements.
We review contracts with Electronic Health Records (EHR) companies, insurance companies, and other medical services vendors. We also draft/review patient contracts involving notices of privacy, assignment of benefits (AOB), etc.
We draft/review contracts, negotiate non-compete agreements, sign-on bonuses, and support clients with any employment contract disputes. We also help physicians understand employment agreement terms.
With the integration of physicians, chiropractors, physical therapists, nurses, psychologists and other allied health providers various legal issues may arise such as corporate practice of medicine issues, fee-splitting, kickbacks, stark issues, employees vs. independent contractors, scope of practice, licensing, professional discipline and malpractice liability. We create contracts and advise on the ways to create these arrangements in order to safeguard providers against legal implications.
We create agreements between business entities and clinical entities.
We review, negotiate and help providers understand provisions of contracts with insurance companies.
We help draft Employment Policies that follow the Texas Workforce Commission recommendations/guidelines. We also draft Independent Contractor Handbooks for companies that regularly use independent contractors.
HIPAA Privacy Rule requires a signed Business Associate Agreement (BAA) with any Business Associate (BA) that may come in contact with Patient Health Information (PHI). We can draft/review agreements or contacts that specifies each party’s responsibilities when it comes to PHI.
We advise clients on formation of Medical Spas, a hybrid between the traditional day spa and a medical clinic. We help clients with understanding the license requirements and the scope of procedures to be performed based on current Texas regulations.
We advise and help clients embrace emerging telemedicine solutions, at the forefront of health care delivery, by assisting with telemedicine program assessment, development, and implementation. We also provide counsel on operational issues and medical records management based on current Texas regulations.
We advise on appropriate employment structure for W2 employees and 1099 independent contractors and the legal implications for the organization and the worker.
Medical Insurance Recovery
We help out-of-network providers negotiate rates with insurance companies when there is network inadequacy of the type of services or procedures offered. If necessary, we support our clients through mediation, arbitration, and litigation proceedings.
Texas is now among more than a dozen states that have cracked down on the practice of surprise medical billing and removed patients from the middle of disputes between a health insurance companies and a hospital or other medical providers. We advise clients on procedures to abide by the recently enacted regulation.
We advise on laws regarding emergency care provided by out-of-network providers and billing for out-of-network services and procedures.
We advise physicians on how to answer important questions on peer-to-peer calls.
We help clients in mediation and hearings through SOAH.
Regulatory Compliance
The most important fraud and abuse laws that apply to physicians are the False Claims Act (FCA), the Anti-Kickback Statute (AKS), the Physician Self-Referral Law (Stark Law), the Exclusion Authorities, and the Civil Monetary Penalties Law (CMPL). It is crucial to understand these laws not only because following them is the right thing to do, but also because violating them could result in criminal penalties, civil fines, exclusion from the Federal health care programs, or loss of physicians medical license from the State medical board. We helps clients understand the risks and review policies to confirm compliance with these regulations.
The Health Insurance Portability and Accountability Act (HIPAA) protects privacy of patient confidential health information and violations are expensive. The penalties for noncompliance are based on the level of negligence. We counsels healthcare providers, suppliers and other individuals and entities to remain in compliance with HIPAA.
