Overview
Business practices that are considered standard in other industries may violate federal and state criminal, civil, and administrative laws that regulate the health care industry. The attorneys in Butzel’s Health Care Industry Group have the experience and legal prowess necessary to help clients meet their business objectives while navigating the maze of laws and regulations unique to this industry. Our experience includes helping clients with professional and facility licensing, corporate practice of medicine, anti-kickback, physician self-referral (Stark law), fee splitting, false claims, Medicare and Medicaid reimbursement rules, fee splitting, professional misconduct, and anti-inducement and solicitation laws.
In many industries, referrals are compensated since they are of economic value to the party receiving the referral. Compensation can take many forms and may range from simple cash payments to advantageous terms in business relationships between individuals in a position to refer business to one another. In many industries, self-referrals are considered commercially usual and customary, and to be a proxy for quality and an extension of a service, good, or item. In the health care industry, this conduct and these relationships can be criminalized, lead to substantial fines, and even exclusion from participation in health care programs.
We offer practical solutions and alternatives to help clients achieve their business and legal objectives and work with clients, and regulators, when necessary, to help avoid and solve regulatory issues. We provide compliant solutions in a wide variety of regulated health care industry relationships, some of which include:
- Integrity audit and compliance programs, policies, and procedures
- Hospital (provider/supplier) and physician relationships
- Anti-markup rules, per click and percentage compensation arrangements
- Strategic alliances
- Joint ventures
- Ambulatory surgery centers (ASCs), cancer centers, heart hospitals, specialty hospitals
- Structuring designated health service ancillary revenue transactions, fixed and mobile imaging and independent diagnostic testing facilities (IDTFs)
- Employment and independent contractor agreements
- Real estate and equipment leases
- Supplier and vendor relationships, including discounts, warranties, formularies, group purchasing organizations
- Buying and selling businesses
- Physician recruitment and retention
- Marketing devices, drugs, and services to health professionals
- Gainsharing, quality focused relationships, and pay for performance programs
- Clinical management service agreements
- Physician organizations, preferred provider networks, and tiered provider networks
- Physician compensation methodologies and valuations
- Telemedicine, outsourcing, and online medicine
- Emergency Medical Treatment and Labor Act (EMTALA) and on call arrangements
