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Litigators For The Health Care Industry
Lashly & Baer, P.C., has represented health care providers for more than 50 years. We are counsel to health systems, national health care group purchasing organizations, dental service organizations, senior living facilities, multi-specialty physician groups, critical access hospitals, rural health centers, imaging centers, ambulatory surgery centers, and individual providers.
The Health Care Advisory Team assists our clients with our breath of knowledge in licensure, regulatory, investigative, and litigation capabilities. We regularly handle the following legal issues for our clients:
Licensure and Credentialing Disputes
- Appeals of regulatory actions by State and Federal agencies
- Facility licensing / certification
- Professional licensing
- Medical staff issues / Peer review proceedings
- Managed care disputes
- Professional liability / Medical malpractice claims
- False claims, anti-kickback and Stark
- Controlled substances (opioids)
- Employment laws and regulations
- Medicare, Medicaid and managed care reimbursement
- Non competes/ Restricted covenants
- Contractual disputes
- Employment disputes
Your License Is Your Livelihood.
Our attorneys have the requisite knowledge and experience to understand the nuances of the health care system needed to defend licensure actions. Most matters start with what appears to be a simple complaint or request for a statement that on its face seems innocuous, but in reality sets the tone for the entire investigation. Our attorneys are experienced in all phases of licensure actions from the initial complaint, to meeting with investigators, to preparing licensees to testify before respective boards, and if needed, litigation before the Administrative Hearing Commission and through the appellate process.
The biggest mistake health care providers make is attempting to handle these types of matters themselves. The best strategy is to involve legal counsel at the earliest opportunity to understand the issues you could potentially be facing and drafting the proper response and creating the narrative from the outset. State licensure efforts have been on the increase in the last several years. We have seen licensure boards become more active and aggressive in pursuing potential disciplinary actions.
Many health care professionals do not realize until it is too late that state licensure boards and registration agencies share information, especially involving the opioid epidemic. You need to be considering interactions with multiple agencies at the investigation stage. We are here to assist in protecting your livelihood. To discuss these matters with our attorneys, contact us at 314-621-2939 or use the contact form.
Health Care Compliance
Health care is one of, it not the most, regulated industries in America. We help our clients stay in compliance with the ever-changing and ever-increasing maze of regulations that affect their business. Not only do we address their problems as they arise, but we also routinely advise clients of new and changing laws and regulations so they can make the necessary adjustments to their policies and procedures before the changes take effect.
Lashly & Baer, P.C., regularly advises all types of providers on Medicare and Medicaid conditions of participation and billing regulations; the Stark Law and its exceptions; anti-kickback and its safe harbors; EMTALA, HIPAA and HITECH, certificate of need appeals, and state licensing laws and regulations for hospitals, nursing homes, imaging centers and other health care facilities. We also advise health care professionals, including physicians, chiropractors, dentists, pharmacists, nurses and physician assistants.
We represent our clients before many administrative agencies, including CMS, Office of Inspector General, MO HealthNet, Certificate of Need, Bureau of Health Facility Licensure, Board of Healing Arts, Nursing Board, Pharmacy Board, BNDD and DEA.
We understand that the myriad of Federal and state health care regulations become so complicated and cumbersome, that health care providers feel that they have a disincentive to pursue new patient care services and product innovations. In collaborating with health care providers, we not only want to provide a road map for compliance with those regulations, but we also try to provide a road map to assist those providers in adding new lines of service or to consider ventures with other health care providers.
We know that in the area of Compliance Plans, “one size does not fit all.” We tailor these Compliance Plan efforts to the size and scope of the provider. We have also found that by collaborating with providers and other professionals such as accountants, coders, and billing companies, our compliance training activities often assist with identifying areas in which the providers are failing to capture the revenue to which they are entitled for their services.
In addition to addressing health care regulatory matters for our health care clients, we also handle the many non-health care regulations they are subject to, including equal employment laws and regulations, wage and hour issues, FMLA, ERISA, land use regulations and similar laws and regulations. For our tax-exempt clients, we advise on state and federal tax law and regulations, including real estate tax exemption, excess benefit transactions and IRS 990 returns.
Our team has significant experience working with clients in federal and state investigations and litigation matters initiated by the Criminal and Civil Divisions at the Department of Justice, United States Attorneys, the Office of Inspector General for the Department of Health and Human Services (“OIG”), the Drug Enforcement Administration (“DEA”), the Food and Drug Administration (“FDA”), State Drug Enforcement Bureaus and Agencies, State Attorneys General, Medicare and Medicaid contractors, and Medicaid Fraud Control Units. We have helped clients avoid potentially devastating civil fines, administrative penalties, and exclusion by combining our team’s knowledge with our investigative, regulatory, and litigation capabilities.
Our team handles investigations that often start with a “knock on the door” from a state or federal agency investigator seeking information and client records pertaining to ever increasingly regulated areas such as Medicare/Medicaid billings, controlled substance prescriptions, FDA compliance, medical device and drug safety issues including investigations and enforcement actions related to the opioid crisis, and illicit referral arrangements among health care providers.
In addition to health care matters, our team is also experienced in general premise liability matters. With many patients, staff, visitors, and vendors visiting your facility, you are at risk for liability against physical property damage, injury, or other negative situations. Our team is ready to investigate and protect the interests of our clients should we need to litigate on their behalf.
We assist clients in responding to these investigations with proactive strategies aimed at completely avoiding – or at the very least minimizing – fines, penalties, exclusion, and negative publicity while preventing disruption to business operations as much as possible. We consistently strive to obtain optimal results for our clients by leveraging our strong relationships with government agencies along with our reputation of integrity and efficiency. Our strategies have produced outstanding results for our clients in avoiding criminal charges from being filed and in mitigating damages sought by the government.
Our team handles all aspects of investigations, from requests for documents, subpoenas or civil investigative demands, to witness interviews and depositions, negotiation with agency personnel and U.S. Attorneys, the structuring of settlements, and as appropriate, corporate integrity agreements or certification of compliance agreements. We also regularly work with clients to facilitate and manage large-scale document production and retention aspects of these investigations.