To be successful in the constantly evolving and highly regulated health care marketplace, you need expert advice and counsel. Hinman Straub sets the standard.
Whatever your health law issue, Hinman Straub will work collaboratively with you to achieve a successful outcome using a customized, problem-solving approach to address your particular need.
Our experienced attorneys and analysts have a proven track-record of assisting clients in meeting their business and strategic goals while successfully navigating the complex maze of Federal and New York State legal and regulatory agency requirements.
Our valued clients include health insurers, health maintenance organizations (HMOs), physicians, dentists, independent practice associations (IPAs), nursing homes, home care agencies, imaging centers, hospices, Article 28 diagnostic and treatment centers, dialysis facilities, federally qualified health centers (FQHCs), adult care facilities (ACFs) and assisted living programs (ALPs), pharmacies, infusion pharmacies, durable medical equipment (DME) providers, mental health providers, and various health plan and professional trade associations.
Whether you are an individual practitioner, group practice, institutional provider, trade association, third party administrator, insurer or HMO, our Health Care Team has the expertise to meet your need to address a wide range of business, operational, strategic and legal issues.
If you are a Chief Compliance Officer or otherwise involved in the management of a Medicaid or Medicare participating provider or health plan, you are acutely aware that the fraud and abuse compliance/enforcement landscape has dramatically changed in the past few years. Key contributors to this “new world” include:
- the new PPACA provision requiring the reporting and return of overpayments within 60 days;
the changes to the Federal False Claims Act and Civil Monetary Penalties Statute enacted by the Fraud Enforcement and Recovery Act of 2009 (FERA);
- the comparable changes to the New York False Claims Act enacted by the “NY FERA” in 2010;
- the aggressive audit, data mining and recoupment efforts of the New York State Office of the Medicaid Inspector General (OMIG), the New York Attorney General’s Medicaid Fraud Control Unit (MFCU), and the HHS Office of the Inspector General (OIG);
- the advent of various recovery audit contractors (RACs, MICs, ZPICs, PSCs, Medicaid RACs); and
- New York’s mandatory “effective” compliance plan requirements.
Hinman Straub has a team of recognized experts dedicated to assisting both provider and health plan clients to meet the challenges of this rapidly evolving compliance environment. Our fraud and abuse group can provide practical, problem-solving and problem-preventing representation and consultation in each of the following specific areas:
- Responding to OMIG Audits
- Reporting and Return of Overpayments
- Compliance with Self Disclosure Protocols
- Development and Implementation of Effective Compliance Plans
- Identifying High Risk Areas and Self-Auditing
Effective representation in today’s complex health care industry requires an array of legal skills delivered in a cost-conscious fashion, coupled with a thorough knowledge of the industry and an excellent grasp of the ever-changing regulatory environment. We provide our clients with the practical insights that come from firsthand experience of years of working in the health care industry, and in regulatory circles.
The health care professionals at Hinman Straub have represented participants in all facets of the health care industry. We offer our clients guidance on a wide variety of matters, including regulatory compliance; implementation of the Patient Protection and Affordable Care Act (PPACA); managed care and third party payor contracting; legislation; as well as premium rate-setting and approvals.
Our experienced health care team combines unparalleled legal experience with a substantial knowledge and understanding of the health care industry.
Long Term Care
Hinman Straub’s expert long-term care group is experienced in representing the spectrum of New York’s long-term care providers, including assisted living residences, Medicaid assisted living programs, nursing homes, home care agencies, and long-term home healthcare programs.
We provide our clients with comprehensive legal services for all types of licensure applications, regulatory enforcement and compliance, litigation, waiver applications and operational matters.
Our clients vary from large publicly traded national companies to small privately held companies and not for profit corporations.
Our team is on the forefront of the unique legal issues and legislative and regulatory developments for the long-term care industry and maintains strong relationships with healthcare policymakers. This knowledge base allows us to provide first-quality services to our clients in an efficient manner.
We understand the business of our long-term care clients, as well as the legal and regulatory landscape in which they operate, allowing us to partner with providers to navigate the constantly evolving New York long-term care landscape.
New York health-care providers have seen an explosion of state oversight and enforcement activities in recent years. With the creation of the Office of the Medicaid Inspector General (OMIG), the aggressive attention of the Attorney General’s Medicaid Fraud Control Unit (MFCU) and the passage (and recent enhancement) of the state’s False Claims Act, the state is determined to aggressively protect taxpayer dollars by pursuing waste, fraud and abuse and by insisting that providers take meaningful steps to police their own activities.
The health care professionals at Hinman Straub have extensive experience with Medicaid and Medicare reimbursement and related issues, and can help you minimizing risks in this area.
In today’s regulatory environment, health care providers are forced to navigate within a labyrinth of complex governmental regulations, and one wrong step can carry drastic consequences. Hinman Straub’s health care professionals can provide unparalleled advice and advocacy to health care providers, including Medicaid and Medicare managed care enforcement; regulatory compliance; obtaining certificates of need; sales, mergers and acquisitions; corporate governance; among other matters.
Our current health care provider clients include adult care facilities (ACFs), Article 28 diagnostic and treatment centers, home care agencies, nursing homes, imaging centers, hospices, dialysis facilities, and individual licensees.