Healthcare

Regulatory, corporate and compliance issues

Healthcare Overview | Team

Healthcare is a highly regulated industry that promises more and more government involvement. Primmer Piper Eggleston & Cramer understands the practices and procedures of the government agencies that oversee the industry and represents a broad array of clients in the healthcare field, which include:

  • Hospitals
  • Nursing homes
  • Community mental health agencies
  • Pharmacies
  • Laboratories
  • Physician practices
  • Other provider groups
  • Medical software businesses

The firm also represents the Vermont Association of Hospitals & Health Systems, the Vermont Health Care Association, and the Vermont Council of Development and Mental Health Services.

Regulatory

The firm represents clients in obtaining the necessary permits, certificates of need, licenses, and financing for healthcare facilities. It assists clients in responding to survey deficiencies and licensure investigations and defends against state enforcement actions and rate setting proceedings. The firm’s attorneys also provide counsel relating to EMTALA (Emergency Medical Treatment and Active Labor Act), and Stark law compliance.

Corporate Issues

The firm assists clients in negotiating and drafting contracts for the following:

  • Purchase of physician practices
  • Joint ventures with other providers
  • Third party payer agreements
  • Employment of professionals
  • Setting rates for nursing homes

Our attorneys also advise and provide services to clients for a variety of corporate issues:

  • Drafting medical staff bylaws
  • Fair hearing procedures and related policies
  • Patient information privacy considerations
  • Antitrust issues pertaining to provider networking and integration
  • Employment policy and personnel issues
  • Governmental and third-party reimbursement
  • Counseling Boards on role and responsibility of governance
  • Private or public financing

Compliance Issues

Corporate compliance programs are essential for avoiding exposure to charges of false or fraudulent billing practices. The firm frequently assists providers in drafting and implementing compliance plans and in responding to contractor and government investigations or other fraud and abuse enforcement activity. It regularly provides training sessions for providers regarding compliance programs and implementing the HIPAA (Health Insurance Portability and Accountability Act) privacy regulations. The firm also provides counsel regarding the requirements of Section 501(c)(3) tax exempt status under the Internal Revenue Code.

Health Information Privacy and Security Compliance 

The privacy and security regulations implementing the Health Insurance Portability and Accountability Act as interpreted with state law provisions require healthcare providers and health plans to develop comprehensive health information policies and compliance strategies. The firm provides training, assistance, and counseling to meet these requirements, including the development of notices and forms, the revision of policies and procedures, and employee training. The firm also works with providers responding to inquiries or allegations of noncompliance. We have been actively developing and providing counsel related to Agreements for electronic health record development and electronic exchange of health information.

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