Healthcare Contract Lawyers
What kind of regulations apply to healthcare contracts?
The health care industry is very heavily regulated. Compliance with all of the federal and state healthcare laws can get complicated. As a health provider, you need to make sure you are in compliance with all regulations. Our firm can help you in all aspects of transactional law to make sure you are in compliance.
What kind of contracts are regulated?
Some of the larger transactions you might face as a doctor such as mergers or associations down to the most mundane of contracts you form with patients are all regulated through federal laws and state laws. Each level of contract can come with certain legal issues, so it is important to make sure each contract is in compliance.
What legal problems can arise from my contracts?
Criminal charges in the health care industry have been on the rise and one area where you can act to make sure you are safe and in compliance is to make sure all of your contracts are in compliance. Some problems your contracts might face include issues of fraud, kickbacks, and self-referrals.
For example, when you enter into a contract with another practice, it is important to have the contract created and reviewed by an attorney with an eye towards compliance with criminal kickback and self-referral laws. If you are in the business of referring clients, there are certain exemptions and rules that you can use, but first, you should speak to your attorney.
How can I avoid charges?
As a health care professional, you should always be taking proactive steps to avoid any criminal liability; which includes making sure your contracts are in compliance. When you enter into a contract, you’ve made a binding agreement to act a certain way. What you need to have an attorney review is if the way you are acting according to the contract is in compliance and if it is legal to enter into the contract in the first place.
In the field of compliance, you are looking to make sure that you are following the laws before any problems arise. If you have any questions about existing contracts or you need help to draft new contracts, you should contact our group of experienced attorneys.
What are kickbacks and self-referrals?
The Anti-Kickback Statute makes it illegal for you to receive any monetary compensation for any referral of clients. Stark Law regulates referrals where a medical professional makes a referral to a practice where the same person has a financial stake. The reason in contracts why these two laws are important to know and understand is that contracts between practices may violate these laws.
What is Health Care Fraud?
When you create a contract, you can also fall into trouble with health care fraud because the actions in the contract or the contract itself may constitute fraud. Health care fraud involves sending bills to an insurance company fraudulently, in an attempt to make more money than what is owed for the services you provide. Health Care Fraud 18 U.S. Code § 1347 makes it illegal to attempt to defraud any insurance company, and several schemes fall under this such as;
- double billing,
- billing for services not rendered, or
- receiving kickbacks.
What punishments might I face under these laws?
The offense of Health Care Fraud comes with a sentence that includes jail time up to 10 years and criminal fines up to $250,000. If any of your patients are injured your sentence can increase to 20 years, and if someone dies you may face life in prison. If you are not proving the proper care for your patients and you are billing for that care, you may face a long sentence.
How can I avoid these charges?
Our contract work has a focus on avoiding any potential pitfalls you may fall into before you fall into them. We will work with you to review your contracts to make sure they comply with the law both retroactively and proactively. We can also help you to create contracts or templates for you to follow to ensure compliance.
How should I form everyday contracts?
Smaller contracts that you enter into every day or even multiple times a day all need to be in compliance with the law; however, having an attorney review every contract is not feasible. This is why the idea of drafting template contracts and training on the templates is so important.
When you create a template for a contract, you also need to make sure that your employees that will enter into the contracts are trained on compliance. The templates that will be formed will provide for the basic framework, but the specifics need to be filled out by a trained employee
What about larger contracts?
The less mundane types of contracts that deal with other practices, such as merger and joint ventures need to be formed or at least reviewed by an attorney. Some of the larger contracts you enter into can form several legal problems so you should proactively review the contracts to ensure that they will not end up with you facing charges.
When you enter into a joint venture, you may be able to exempt yourself from the Stark law and the Anti-Kickback Statute. The exemptions that are in these laws for joint ventures are somewhat complicated and nuanced so having an attorney that has experience will make the difference between a compliant and a possibly non-compliant joint venture.
How can I tell if I need an attorney to review the contract?
The larger deals that you enter into should always be reviewed first by an experienced transactional attorney but there comes the point when smaller transactions may not be as feasible to have every transaction reviewed. For these day to day transactions, you can work with your attorneys to create templates and internal regulations to prevent any problems with these transactions. Your attorney should also be reviewing these transactions routinely at a macro level to ensure compliance.
What does it mean to be in compliance?
The largest part of our jobs as your attorney working in transactional work is making sure you are in compliance with the law. Federal and State regulations set up countless restrictions and rules that you must follow in the healthcare field. These legal requirements can get quite complicated which is why we will help you understand what the rules are and make sure you comply with the rules.
If one is found to not be in compliance with the law, there are several penalties that may befall you, such as, losing a medical license, criminal punishments including the possibility of jail time, civil monetary penalties, and several other reputational harms. You should work to avoid these punishments by getting ahead of any potential violations though working on compliance with each transaction.
What should you do?
If you need any help either forming or reviewing any of your contracts you should contact our experienced attorneys to help you through this process. We have experience in defending criminal cases, so we know what pitfalls you need to avoid to be compliant, and we have experience working with compliance.
Our experienced attorneys know how important it is for you to stay in compliance to avoid legal troubles so we will work hard for you to ensure compliance. If there are any problems with your contract that lead to legal troubles we will also be able to defend against any charges you may face.