What We Do

Health Plans and Insurance

  • Statutory and regulatory compliance work involving ADA, ERISA, HIPAA, COBRA, HMO and participating provider relationships
  • Patient Protection and Affordable Care Act (and related federal health care reform) compliance work

Healthcare Providers and Facilities

  • Litigation, arbitration and mediation on disputes including collections, subrogation liens and reimbursement rights
  • Representation in credentialing disputes and due process hearings
  • Certificate of Need applications before the State Health Planning and Development Agency and related contested case proceedings
  • Regulated Industries Complaints Office disputes and hearing process regarding licensure
  • Emergency court orders for guardianships and emergency treatment issues
  • Petition the Family Court for appointment of guardians of incapacitated persons
  • Petition the Probate Court for appointment of guardians of the property and personal representatives
  • Work closely with the Office of the Public Guardian, Adult Protective Services, the Attorney General’s Office, hospitals, care homes and nonprofit service organizations to ensure care for incapacitated persons
  • ┬áStatutory and regulatory compliance work involving ADA, ERISA, HIPAA, ACA, COBRA, RICO, Medicare, Medicaid, QUEST, Patient Bill of Rights and Responsibilities and related programs
  • Credentialing, peer review and healthcare quality issues
  • Payment disputes
  • Medical record-keeping practices, confidentiality and HIPAA compliance
  • Medical staff bylaws and staff relationships
  • Certificates of need and licensure
  • Collections, liens and reimbursement rights
  • Federal and state privacy laws, special classes of information (such as HIV/AIDS, mental health and substance abuse), and common law and statutory privileges
  • Risk management: advice on issues regarding medical malpractice, EMTALA, Patient Bill of Rights, and confidentiality; draft risk prevention policies and informed consent forms; present seminars on risk management issues
  • Physician and staff inquiries and emergency legal needs

HIPAA

  • File objections to requests for information that are not HIPAA-compliant
  • Pursue remedies for breaches of confidentiality
  • Legal notices of privacy practices, business associate agreements, written assurances and authorizations that are HIPAA-compliant
  • HIPAA Privacy Rule, HITECH Rule, HIPAA Security Rule and related compliance issues for health plans, health care providers, health care clearinghouses, employers, and other entities