At Weaver Johnston & Nelson, we take pride in assisting physicians, hospitals, surgery centers and other medical providers in navigating the complex regulatory environment in which they operate. Our lawyers know the healthcare industry is an ever-changing and expanding area that requires medical providers to be constantly up-to-date on the latest changes and reforms that occur. That is why endeavor to give our clients the timeliest, most current advice we can. With a diverse background of experience between our attorneys, our firm has the expertise to effectively serve our clients.

We routinely assist our clients in matters ranging from the transactional to the litigious. We believe that, because the healthcare industry is so quick to evolve, it is essential to provide personalized, exceptional service to medical providers.

Areas of Focus

Accountable Care Organizations, or ACOs, are groups of healthcare providers, including doctors, hospitals, and health plans that join together to provide coordinated, quality care to patient populations.

We understand that audits can be intimidating for our clients, so we ensure our responses to audits are timely, professional and thorough.

The penalties for being noncompliant in the healthcare industry are severe, so we work to create robust compliance programs that allow organizations to comply with strict industry regulations and to train their employees to effectively recognize and deal with any compliance issues that may arise.

EMTALA, or the Emergency Medical Treatment and Labor Act, is crucial for hospitals to adhere to in their daily operations. Hospitals must provide an appropriate screening for emergency medical conditions and stabilization for individuals who come to their premises with an emergency medical condition.  If hospitals or providers violate EMTALA, it could lead to fines up to $50,000 for each violation and exclusion from Medicare. The government takes both EMTALA and any violations of it very seriously, and hospitals have an obligation to comply with this act if they wish to avoid those penalties.

Any person who knowingly presents a false or fraudulent claim to the U.S. government for payment is liable for substantial penalties, plus three times the amount of damages sustained by the government because of that claim. Because of the heavy penalties involved, it is imperative that medical providers understand what constitutes a violation of the False Claims Act and what the ramifications of any violation are. We have a great wealth of knowledge and background on compliance with the False Claims Act and responding to any potential violations of the False Claims Act.

The Federal Anti-Kickback Statute is one of the most important statutes in the healthcare industry. It prohibits the exchange of remuneration, or anything of value, in return for referring an individual or providing items or services for which payment may be made under a Federal healthcare program. The penalties are very stiff for medical providers who violate this statute; violators can be fined up to $25,000.00 and excluded from the Medicare and Medicaid programs, as well as face prison time. Medical providers have to tread very carefully in conducting their daily business to be sure they comply with this statute.  We are here to advise our clients on how to comply with the Anti-Kickback Statute.

One focus of our attorneys is advising the Firm’s clients on HIPAA compliance. With technology advancing at an astounding rate, it is easy for medical providers to fall vulnerable to breaches of patient information. We make it a priority to ensure that providers are well equipped to protect patient health information and properly prepare for any situation that may occur. To bolster this goal, we provide thorough HIPAA training to our clients that covers everything from what counts as PHI to how breaches are investigated and reported. It is critical for medical providers to have stringent compliance and security programs in place so they can serve their patients effectively and keep their most private information safe.

Hospitals make up a significant portion of our clientele, and so we have a deep understanding and knowledge of hospital conditions of participation and other regulations that pertain to their operations.   Our attorneys have been involved in all aspects of the development, licensing, accreditation and Medicare enrollment of hospitals.  We often serve as outside general counsel to hospitals and advise them on all legal matters that pertain to them.  In addition, our attorneys have extensive experience advising physician-owned hospitals on the complex regulations that affect their day-to-day operations. 

We often advise our clients on licensing, certification and accreditation.

We have particular litigation experience in reimbursement matters, audits, bad faith cases, health-care related collection cases, and disputes with payors. 

We have extensive experience in assisting our clients with initial enrollment, as well as updating and changing their Medicare enrollment information.

In addition to our health compliance experience, we also have significant transactional experience, including assisting our clients in mergers and acquisitions.

The Patient Protection and Affordable Care Act has deeply impacted our clients.  Like the healthcare field itself, it has been subject to revision, constant change and even outright deletion. We make sure to keep our clients updated on the latest changes to this important act and make sure that the team is fully aware and keeping tabs on any new developments that come along.

We work with many pharmacies and have developed an extensive working knowledge in the laws and regulations that govern pharmacy operations. It is critical that pharmacies have experienced counsel on hand to ensure they stay within the boundaries of those regulations, and we are proud to assist our clients with all aspects of pharmacy law.

The Physician Self-Referral Law, commonly known as the Stark Law, prohibits physicians from making referrals of “designated health services” to an entity with which the physician, or an immediate family member of the physician, has a financial relationship. This is another statute in which medical providers must comply. Much like the Anti-Kickback Statute, there are stiff penalties for violating the Stark Law. Violators may be significantly fined for violating the Stark Law and subject to False Claims Act violations for violating the Stark Law. We work hard to ensure our clients’ business arrangements are not in violation and have particular experience in ensuring compliance with this act.

We have a broad range of experience in helping our clients become and stay compliant in the wake of the numerous regulations and statutes that govern the healthcare industry. We know how difficult it is to keep track of all of these regulations, so it is always a priority to keep our clients aware of any laws that may affect their compliance.  We often serve as outside compliance officers for clients and assist in developing and implementing robust compliance programs.

We are well versed in reimbursement and payor audits and have extensive experience in assisting clients in responding to these types of audits.

Similar to the Federal Anti-Kickback Statute, the Texas Illegal Remuneration Act prohibits a person from paying or agreeing to accept remuneration for referring patients. Penalties for violators include a civil penalty of up to $10,000.00 for each day and act of violation, and they could face disciplinary action from the agency that issued their license or certification. Our team members have an extensive knowledge of this act and take pride in competently advising medical providers on issues that arise from this act.

Professionals We Serve

  • Ambulatory Surgery Centers (ASCs)
  • Chiropractors and Chiropractic Practices
  • Clinical Trials Companies / Medical Research
  • Clinically Integrated Networks (CINs)/ Accountable Care Organizations (ACOs) / Independent Physicians Associations (IPAs)
  • Dentists and Dental Practices
  • Digital Health Providers (Telehealth)
  • Durable Medical Equipment Providers
  • Franchise Retail Healthcare Providers
  • Freestanding Emergency Medical Care Facilities / Emergency Departments
  • Imaging Centers
  • Laboratories
  • Management Service Organizations (MSOs) and Dental Support Organizations (DSOs)
  • Mid-Level Providers including Physician Assistants and Advanced Practice Registered Nurses
  • Pharmacies
  • Physician Staffing Companies
  • Physicians and Physician Organizations
  • Post-Acute Providers (Nursing Facilities, Assisted Living, Home Health Agencies, Hospice Providers)
  • Public, Private and Physician-Owned Hospitals (General, Acute Care, Psychiatric and Rehabilitation)