Health Law Practice Group

Health Law Practice Group

Our health care clients face numerous and complex regulatory, transactional and compliance challenges, as well as increasing government scrutiny. To help meet these challenges, we proactively assist our clients and defend our clients if necessary, in the following areas:

• Provide compliance guidance associated with government program participation, i.e., EMTALA, MMA, DRA, and other federal and state requirements
• Review transactions and reimbursement issues for compliance with federal and state fraud and abuse requirements
• Advise regarding reporting obligations under NPDB, patient safety, accreditation and other data reporting laws and regulations

Government Audits, Investigations, Subpoenas and Related Litigation

• Assist or conduct internal audits and investigations
• Provide advice regarding making self disclosures to the government
• Assist in response to government investigations and enforcement actions, including administrative subpoenas, grand jury subpoenas, and search warrants
• Negotiate Corporate Integrity Agreements, and advise on related compliance issues
• Proactive counseling regarding avoiding whistleblower and false claims actions
• Related litigation defense

Reimbursement and Managed Care

• Provide guidance regarding Medicare, Medicaid and commercial payor reimbursement, including regulatory requirements and evolving payment methods, i.e., pay-for-performance, value-based purchasing and gainsharing
• Assist with managed care contract negotiations and payment disputes
• Advise health care providers, health plans and plan vendors regarding regulatory requirements of federal Medicare Advantage and Part D prescription drug and state Medicaid managed care programs

Health Care Transactions

• Draft and negotiate variety of health care contracts between and among hospitals, physicians, health plans and provider and plan vendors
• Provide health care regulatory due diligence assistance for joint ventures, acquisitions and other transactions
• Assist with regulatory and payor notice and approval requirements related to changes of ownership

Licensure and Accreditation

• Secure and maintain health care facility, professional and health plan licensure and certification; provide counseling on licensure deficiencies and disputes
• Provide guidance regarding accreditation standards, including Joint Commission, NCQA, URAC, and assist with accreditation surveys and responses

Health Information Privacy and Security

• Develop and revise HIPAA-compliant policies, procedures and business associate agreements
• Interpret and advise on federal and state privacy and security laws and regulations, including the interplay between HIPAA and state health information privacy laws and regulations
• Assist with responses to allegations of HIPAA violations and electronic health information security breaches, including responses to patients and government agencies

Hospital-Medical Staff/Plan-Provider Relationships

• Draft and interpret medical staff bylaws, credentialing policies and fair hearing plans
• Advise hospitals, health plans and peer committees throughout the peer review and fair hearing processes
• Serve as fair hearing officer

For further information, please direct inquiries and referrals to:

Katherine M. Keefe, Esquire
Health Law Practice Group
Marshall, Dennehey, Warner,
Coleman & Goggin
620 Freedom Business Center
Suite 300
King of Prussia, PA  19406
Direct Dial:  (610) 354-8270
Fax:  (610) 354-8299
Email:  kmkeefe@mdwcg.com