If you’re a physician with a private medical practice or have a business that operates within the healthcare sector, you’re probably aware that there are many complex laws within this industry. These laws frequently change and are often complex. Ensuring regulatory compliance can be difficult, particularly for private businesses without internal legal departments.
This article describes several ways that a healthcare attorney assists private healthcare practices with regulatory compliance and protection against liability.
1. Healthcare contracts
The medical profession offers contracts to various employees. For example, many doctors sign contracts to work for a particular hospital or practice. An attorney may help write this contract or examine one before a physician signs an offer.
Another important legal document involves partnerships between medical professionals. These agreements may be complicated and must be legally sound. Contracts usually include compensation details, non-compete clauses, ownership percentages, benefit packages, retirement information and more.
A well written contract protects employers and employees. So, it’s extremely important to hire an attorney specializing in healthcare contracts. Doing so will help to avoid future legal complications.
2. Contract disputes
Sometimes a medical professional experiences a legal issue related to an existing contract. For example, problems may occur in a partnership when one party leaves a group and wants to dissolve an existing contract. In this situation, legal advice is mandatory to resolve any disputes regarding finances and/or patient lists.
Usually terms for dissolving partnerships are established in the original partnership agreement. However, if one party does not follow the original agreement; there are legal ramifications.
3. Compliance with HIPPA regulations
The Health Insurance Portability and Accountability Act (HIPPA), a federal law passed in 1996, protects patients’ health information. HIPPA dictates that medical professionals may not release information about any patient to a second party without the patient’s written permission. HIPPA violations can include heavy fines and prison terms.
So, if a hospital, pharmacy, laboratory or other medical professional is accused of violating HIPPA, an attorney can assist clients during investigations and provide a solid defense during a civil or criminal trial.
In today’s world, medical records are stored in computers. Sadly, these systems may be “hacked” by criminals. Organizations are not liable for these events IF proper precautions are in place. In other words, the organization must have installed proper security and performed background checks on employees. In other words, when entire medical computer systems are broken into it may or may not violate HIPPA depending on previous actions.
4. Compliance with Anti-Kickback Statutes
People involved in the healthcare industry may not accept money or rewards for referring patients. Of course, medical practitioners may refer patients to specialists, labs, testing facilities, etc. However, they may not be “rewarded” for these referrals. In addition to the federal statute, Florida has numerous statutes regarding kickbacks. Each statute is specific and requires an attorney’s interpretation.
Failure to comply with Florida’s strict laws may be a felony. If convicted, an individual may face imprisonment, fines, or loss of license. Since violating anti-kickback laws carry civil and criminal penalties it’s important to discuss all business arrangements with a lawyer.
Also, if a medical professional or organization is accused of violating any anti-kickback statutes call an experienced healthcare attorney that understands governmental rules, regulations, and statutes.
5. Stark Law Compliance
Stark Law forbids physicians from referring Medicare or Medicaid patients to any facility in which the doctor has a financial interest. For example, if a doctor, or one of his family members own a nursing home, the doctor may not send Medicare or Medicaid patients to that facility. Stark Law applies to physicians and does not require intent for a conviction.
So, if a doctor is unsure of any referral situation, or is accused of violating Stark Law, talk to a lawyer before making referrals.
6. Defense against the False Claims Act
State or Federal Attorneys use the False Claims Act to combat fraud against the government. This federal statute prohibits falsely billing the government for medical services. It also forbids underpaying what one owes the government. For example, if a medical practice knowingly files a false claim to Medicare or Medicaid that is a violation of the False Claims Act. Of course, medical facilities occasionally make mistakes and mix up records. Consequently, when a practice or individual is accused of violating the False Claims Act it’s paramount to retain legal counsel.
Healthcare is an ever-changing, complex industry and an overall complex area of law. A law firm that specializes in healthcare can help businesses that are involved in this sector ensure compliance with various federal and state laws and protect them against potential lawsuits.