Healthcare Law

In the highly regulated field of healthcare, it is essential to secure the assistance of an attorney who understands the distinct legal and regulatory pitfalls which present themselves on a regular basis. The attorneys of Weiss Zarett Brofman Sonnenklar & Levy, P.C., are skilled in the representation of various members of the healthcare industry in a wide array of legal services, including corporate and transactional matters, civil and administrative litigation, healthcare compliance issues, real estate transactions, payor audits and investigations, data privacy issues under HIPAA/HITECH and professional licensing defense. Clients of Weiss Zarett include physicians, medical practices, ambulatory surgery centers, laboratories, chiropractors, nurses, and other medical providers and health-related businesses.

AUDITS AND INVESTIGATIONS

The attorneys at Weiss Zarett routinely represent healthcare providers and facilities in preparing for and responding to audits and site visits for an array of state and federal government agencies, including Medicare, Medicaid, and private insurance carriers. Our attorneys assist clients with responding to subpoenas and requests for information, responding to and appealing audit reports and overpayment demands, helping clients to be removed from pre-payment audit review, negotiating settlements and corporate integrity agreements, developing corrective action plans, attending administrative hearings at both the state and federal level, as well representing health providers in civil court litigation on such matters. We work with billing and coding experts, as well as statistics experts in order to help achieve the best possible results. Payors and regulatory entities with which we commonly work include:

  • CMS – Centers for Medicare & Medicaid Services
  • RAC – Recovery Audit Contractor Audits
  • ZPIC – Zone Program Integrity Contractor Audits
  • MAC – Medicare Administrative Contractors Audits
  • Medicaid (New York)
  • OMIG – Office of Medicaid Inspector General
  • MFCU – Medicaid Fraud Control Unit
  • DOH – New York State Department of Health (DOH)
  • NY AG – New York State Attorney General 
  • OIG – United States Department of Health and Human Services, Office of Inspector General 
  • IRS – Internal Revenue Service
  • DOJ – United States Department of Justice 
  • Commercial (Managed Care) Payor Audits and Investigations

CLINICAL STAFF PRIVILEGES

The attorneys at Weiss Zarett are uniquely skilled at representing physicians and other healthcare providers with respect to matters involving their medical staff privileges at academic and community hospitals, as well as larger health systems. A healthcare provider’s hospital affiliations and privileges are often central to the provider’s practice. The denial, loss or curtailment of those privileges are typically reportable to the National Practitioner Data Bank and could adversely affect future practice and employment opportunities and professional credentialing efforts. The recent trend of physician employment by hospital systems adds complexity and importance to these disputes.

Our attorneys have many years of experience representing healthcare providers who are being denied medical staff privileges, or who are at risk of losing their privileges through corrective actions or disciplinary proceedings. Whether it is a summary suspension, a “due process” hearing, the Public Health and Health Planning Council proceedings or a judicial action to challenge adverse actions against privileges, our attorneys provide guidance in navigating this unique succession of grievance, appeal and litigations proceedings. We also frequently assist physicians in matters involving allegations of “disruptive behavior” or drug/alcohol/psychiatric impairments, and residents and fellows threatened with probation, suspension or termination from training programs and related ACGME issues.

We also assist clients in reviewing their medical staff structures and bylaws and provide counsel relating to medical staff leadership challenges.

FRAUD & ABUSE AND REGULATORY COMPLIANCE

The attorneys of Weiss Zarett have extensive knowledge of the regulatory and corporate compliance issues relating to the healthcare industry. We routinely work with our clients to plan and structure their business relationships and transactions to comply with applicable federal and state laws and regulations, including those relating to compensation and financial arrangements with professionals and non-professionals.  We also advise our clients on potential fraud and abuse concerns and provide regulatory compliance advice on numerous subjects, including:

  • Stark Law – Federal Physician Self-Referral Law and State self-referral laws
  • AKS – Federal and State Anti-Kickback Statutes and Regulations
  • CMP – Civil Monetary Penalties Law  
  • FCA – False Claims Act  
  • HIPAA – Health Insurance Portability and Accountability Act  
  • HITECH – Health Information Technology for Economic and Clinical Health Act
  • OSHA – Occupational Safety & Health Administration  
  • I-STOP/PMP – Internet System for Tracking Over-Prescribing
  • Advertising Regulations
  • Medicare’s Anti-Markup Rule
  • New York Physician Profile Requirements
  • Employment Practices Compliance
  • Compliance Program Development and Monitoring

HEALTHCARE LITIGATION AND ARBITRATION

The attorneys at Weiss Zarett handle a wide range of healthcare litigation and arbitration proceedings from inception through trial. We have extensive experience handling pre-trial investigations, discovery, depositions, motion practice, and trial preparation – as well as appeals –before state and federal courts. We are also fully familiar with alternative dispute resolution proceedings such as arbitration and mediation before the American Arbitration Association (“AAA”) and others.

While litigation and arbitration can be protracted and expensive, our attorneys handle matters in a cost-effective and efficient fashion. As a boutique law firm, we are able to offer practical and individualized guidance to create a litigation strategy that works best to accomplish our clients’ objectives within a reasonable cost structure.

Litigations and arbitrations handled by Weiss Zarett include matters related to the following:

  • Restrictive Covenants and Non-Solicitation Agreements
  • Business and Partnership Disputes
  • Breaches of Contract
  • Employment Matters
  • Compensation and Severance Disputes
  • Shareholder Disputes
  • Fraud and Misappropriation

PROFESSIONAL DISCIPLINE AND LICENSING

Weiss Zarett has extensive experience when it comes to representing healthcare professionals in connection with OPMC and OPD investigations. Our attorneys regularly guide healthcare professionals through the entire disciplinary process, which may include reviewing of medical records, consulting with experts, preparing for and participating in an Interview with the investigator, and negotiating the terms of Consent Orders. The Firm’s experience covers with numerous licensing and disciplinary agencies and distinct legal issues, including

  • OPMC – Office of Professional Medical Conduct
  • OPD – Office of Professional Discipline  
  • CPH – The Physician Health Program for New York State the Committee for Physician Health  
  • Mental Health and Substance Abuse
  • OASAS – New York State Office of Alcoholism and Substance Abuse Services
  • New York Physician Profile Requirements

Telemedicine & Telehealth

The attorneys at Weiss Zarett Brofman Sonnenklar & Levy, P.C., have the experience necessary to assist with telemedicine program assessment, development, and implementation.  Telemedicine, online medicine and e-health is the future of medicine, and our attorneys are at the forefront of the legal and regulatory issues concerning this cutting-edge area. Our attorneys will draft contracts concerning telemedicine projects, as well as offer guidance as to how to navigate the many legal challenges affecting telehealth in order to minimize risk and maximize reward.

Related Articles

Areas of Healthcare Law Practice