Health care providers are becoming more heavily regulated by federal and state agencies. Increasingly, health care providers are subject to investigations and qui tam litigation based on allegations of health care fraud, improper billing practices, or other health care law violations.
Health Care Law Compliance
The likelihood of being investigated or being subject to qui tam litigation for health care fraud or other health care law violations is minimized when health care providers institute effective compliance programs. DEMING PLLC works with clients to develop, implement and monitor effective compliance programs, including policies, practices, and procedures, as well as adequate internal controls.
Billing Compliance Programs
DEMING PLLC offers health care providers, including hospitals, clinics, nursing homes, doctors, dentists, pharmacists and ambulance services, assistance in developing and implementing billing compliance programs to minimize the risk of health care fraud investigations and related qui tam litigation arising out of allegations of:
- Medical billing fraud
- Medicare fraud
- Medicaid fraud
- Insurance fraud
- Mail and wire fraud
- HIPAA violations
Medical Billing and Health Care Fraud Investigations
DEMING PLLC represents health care providers when investigations arise. With extensive white-collar experience, it has the knowledge and perspective for working through complex and difficult issues to achieve a constructive resolution with government officials. Where necessary, DEMING PLLC conducts internal investigations and prepares whatever reports or disclosures may be required by government officials. While focusing on the best interests of health care providers, it is practical and sensitive to avoiding unnecessary costs in its approach.
The U.S. Congress passed the Health Insurance Portability and Accountability Act (HIPAA) in 1996 in order to allow U.S. workers the opportunity to change health insurance providers when they transitioned from their current position with some protection of confidentiality regarding their medical records. One of the most important components of HIPAA is that the federal law preempt state laws regarding changing health insurance providers and medical records.
Lawyer for Appeals for Providers of Health Care Services
In addition to representing health care providers with respect to investigations and related litigation, DEMING PLLC represents health care providers in all aspects of the Medicare appellate process, including pursuing an appeal in federal court.