Physicians and midlevel providers, such as nurses and physician assistants, face numerous legal challenges. Whether it relates to compliance with applicable state and federal laws and third party payor rules on a day-to-day basis or in a complex transaction, physicians and midlevel providers require legal expertise that targets the health care laws that affect their practices.
Benkoff Health Law has specific expertise in providing regulatory guidance pertaining to HIPAA and other privacy laws and various fraud and abuse laws including, without limitation, the federal Anti-Kickback Statute and Stark. Benkoff Health Law also provides physicians and midlevel providers with ongoing legal advice relating to their day-to-day practice operations, as well as drafting and revising compliance programs, policies and procedures.
Benkoff Health Law is experienced in advising physicians and midlevel providers with respect to health care transactions and agreements and compliance with state and federal laws that impact those transactions and arrangements. In addition, we regularly provide health care corporate legal guidance to physicians and midlevel providers with respect to structuring new entities, restructuring existing entities, and advising as to appropriate methods for business combinations (e.g., mergers, sales, and acquisitions).
Physicians and midlevel providers must ensure that they comply with a myriad of health care regulatory requirements and third party payor rules on an ongoing basis. Benkoff Health Law regularly advises physicians and midlevel providers with respect to HIPAA and state patient privacy obligations. In addition, we have extensive experience in providing guidance to ensure that physicians and midlevel providers comply with federal and state fraud and abuse laws, such as the federal Anti-Kickback Statute and Stark, which often implicate arrangements in which physicians have financial relationships with entities that they refer patients to.
State supervision regulations, government payor requirements, and third party payor requirements often apply to the relationships between physicians and midlevel providers. Even outside of supervision requirements, physicians and midlevel providers often face challenges in complying with Medicare, Medicaid and third party payor billing requirements.
Benkoff Health Law regularly advises physicians and midlevel providers with regard to HIPAA and state privacy laws, federal and state fraud and abuse laws, physician supervision laws and payor requirements, and other billing requirements. In addition, we assist physicians and midlevel providers in preparing comprehensive compliance programs, policies and procedures, as well as patient forms and related documents.
Transactions and Agreements
Physicians and midlevel providers often require agreements for certain relationships including: employment agreements, independent contractor agreements, health care entity sale and acquisition agreements, equipment and space leases, equipment and real estate purchase agreements, joint venture agreements, management agreements, supply purchase agreements, and professional service agreements. We specialize in advising physicians and midlevel providers regarding arrangements involving other healthcare providers and entities, such as hospitals, laboratories, pharmacies, ambulatory surgery centers, and other health care facilities. We also assist physicians in structuring arrangements with non-healthcare providers, such as private equity firms and management service providers. Benkoff Health Law regularly drafts and negotiates a broad range of agreements for physicians and midlevel providers to ensure compliance with applicable health care regulations.
We also have expertise in drafting and revising corporate and organizational documents, such as corporate bylaws and company operating agreements, buy-sell agreements, and similar documents. The structure and terms pertaining to transactions and agreements in the health care industry are subject to health care regulations and third-party payor rules. For example, federal and state fraud and abuse laws, such as the federal Anti-Kickback Statute and Stark, often impact the structure and terms of deals involving physicians and midlevel providers. At Benkoff Health Law, we focus on ensuring both that agreements are tailored to our clients’ business and legal needs and that our clients understand the terms of the agreements that they are entering into.
Physicians and midlevel providers who own businesses in the health care industry must ensure that they structure their corporate arrangements in a manner that complies with health care regulatory laws. Benkoff Health Law is experienced in advising physicians and midlevel providers with respect to opening their own practices as well as ventures with other health care providers, such as hospitals and other health care entities, and with non-healthcare providers, such as private equity and venture capital firms.
Physician and midlevel provider investments in health care entities and sales, acquisitions and mergers in the health care industry implicate many health care laws including, without limitation, facility licensure laws, corporate practice of medicine laws and fraud and abuse laws, such as the federal Anti-Kickback Statute and Stark. Benkoff Health Law strives to offer physicians and midlevel providers viable options for corporate structures that meet business goals while complying with applicable health care regulations. We also regularly work with attorneys who specialize in tax, securities, merger and acquisition and corporate law to provide health care industry legal expertise and contractual assistance.
For more information about federal resources pertaining to physicians, please see CMS’s Physician Center page.