Representing Licensed Providers in All Legal Matters
As a healthcare provider, your license is not only your gateway to treating patients; it’s also your ability to provide for yourself and your family. We know that you got into this business to provide care to those who need it. Let us help you protect your license so that you can focus on your mission and practice for as long as you desire.
Our Services for Licensed Providers
We help licensed providers manage their legal risks so that they can focus on serving their patients. Our services include proactively mitigating risks by implementing compliance into your practice and reacting to audits, investigations, and enforcement proceedings. If you are a licensed provider, contact us for more information about our services in areas including:
Business and Employee Matters
Whether you are starting your own solo or group practice, bringing on a partner or employees, or revisiting your current agreements, we can help you evaluate your options, make informed decisions, and get the appropriate documents in place.
Silverman Bain, LLP, has extensive experience helping providers navigate business purchases, mergers, acquisitions, and sales. Healthcare providers have to navigate unique laws designed to keep the focus primarily on effective patient care. We also draft and negotiate all types of contracts with a keen eye toward legal compliance. Effective risk management requires comprehensive knowledge of healthcare laws, and careful drafting and negotiation.
Licensed providers have extensive regulatory compliance obligations, especially when billing Medicare and Medicaid beneficiaries. However, third-party payors are protected by their own federal and state laws, so simply avoiding federal payors isn’t a fool-proof method to avoid risk. Michael Silverman and Jacqueline Bain have worked with numerous providers to help them develop, implement and manage comprehensive and custom-tailored regulatory compliance programs to steer clear of “red flags,” navigate audits, and build payor relationships that last.
Stark Law and Physician Self-Referrals
One issue of particular concern for licensed physicians is the issue of Stark Law compliance. The Stark Law prohibits “self-referrals” for certain designated health services from physicians to entities in which they have an ownership or other financial interest. Each self-referral prohibition, including the Stark Law, is subject to exceptions, and maintaining compliance is often a matter of structuring a relationship so that one of these exceptions applies.
When a person receives anything of value in return for referring a patient for a healthcare item or service, that relationship has the potential for fraud and abuse. We help our clients understand their obligations to avoid such situations. Allegations can lead to substantial liability exposure for licensed providers. We defend providers against these allegations in private insurance, state, and federal audits and investigations.
Supervision Requirements and Other Legal Risks for Physicians
Sometimes licensed providers require professional supervision to perform. Other times, healthcare businesses owned by lay persons require a medical director to oversee the professionals on-site. Supervision requirements can present liability and enforcement risks for physicians, physical therapists, and behavioral health professionals who are not careful. As healthcare lawyers with decades of combined experience, we are well-versed in the issues that can (and often do) get licensed providers into trouble, and we know what it takes for providers to protect themselves.
Issues with private insurance companies, Medicare, Medicaid, TriCare, and other payors can disrupt licensed providers’ practices, and they can prove costly without effective management and resolution. We effectively navigate such payor issues for our clients, from securing payment for denied claims to successfully defending against payor audits and investigations.
Licensure Issues and Board Representation
Losing your license can have devastating consequences as a physician or other licensed healthcare provider. If you are dealing with a licensure issue, our lawyers can work with you to build an effective defense strategy, and we can represent you before your state licensing board if necessary.
Schedule an Appointment with a Healthcare Lawyer Today
At Silverman Bain, LLP, our practice is devoted to representing licensed providers and other healthcare entities. Both Michael Silverman and Jacqueline Bain were raised by licensed healthcare providers, and they understand how business and personal lives can be disrupted because of the unique issues such providers face. We have an intimate understanding of the issues our clients face on a day-to-day basis, and we know what it takes to overcome these issues successfully. To discuss your legal needs with one of our experienced lawyers in confidence, please contact us today.