Healthcare

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.