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Health Care Compliance

Related Practices

Rankings & Honors

  • U.S. News/Best Lawyers has named Nixon Peabody “Law Firm of the Year” in Health Care Law in 2016
  • “Deal of the Year” for Health Care Financing by The Bond Buyer for Presence Health Network 2016 bond offering
  • Ranked nationally in U.S. News/Best Lawyers “Best Law Firms” in Health Care Law and received metropolitan rankings in Health Care Law in Albany, Boston, Chicago, Los Angeles, New York City and Rhode Island
  • Ranked in Illinois, Massachusetts and New York for Healthcare in Chambers USA: America’s Leading Lawyers for Business
  • Ranked nationally by Modern Healthcare—Largest Healthcare Law Firm
  • Recognized lawyers by Best Lawyers in America in the field of Health Care law
  • Recognized lawyers by Super Lawyers in the area of Health Care law
  • Recognized by the American Bar Association’s Health Law Section in its Annual Regional Law Firm Recognition Program
  • Recommended in The Legal 500 United States 2016
 

HEALTH CARE COMPLIANCE

We merge our transactional practice with our nationally recognized governmental investigation practice to prevent compliance violations and investigate and defend compliance lapses.

Our Approach

Health care fraud has become one of the top priorities of our current administration.

Our attorneys establish, implement and monitor compliance programs that prevent, detect and correct practices that fail to comply with the complex fraud and abuse laws governing the provision and billing of health care services. And if we identify violations, we quickly prevent further illegal activity and minimize penalties.

An effective compliance program is key to the success of a health care provider’s operations and business ventures. We help to prevent violations of Medicare and Medicaid anti-kickback laws, Stark laws and related self-referral prohibitions, the False Claims Act and other laws presenting risks for potential criminal and civil liability.

Additionally, we counsel and defend clients in connection with investigations and prosecutions of health care fraud allegations by both federal and state entities. We work on many False Claims Act-driven government investigations, including:

  • Emergency room E&M coding initiatives
  • Laboratory unbundling initiatives
  • Pneumonia upcoding reviews
  • Laboratory investigations
  • Investigational devices issues
  • PATH audits and investigations
  • DRG 72-Hour Window claims

When necessary, we also negotiate and fulfill the obligations under corporate integrity agreements.

We work with

  • Hospitals and health systems
  • Medical device manufacturers
  • Physicians
  • Other health care providers

Media Clips

  • 6 Ways to Be a Go-To Firm for HIPAA Compliance
    Law360 | April 29, 2016
    Chicago health care partner Valerie Breslin Montague is included in this piece that looks at how attorneys are dealing with increasing Health Insurance Portability and Accountability Act (HIPAA) penalties and audits.
  • Are Employers Responsible for an Employee's Unauthorized Review of a Patient's Confidential Health Information?
    Journal of the American College of Radiology | May 1, 2015
    This contributed column discusses employer liability for employees who improperly access confidential patient information. This piece is authored by Albany Health Care partners Laurie Cohen and Peter Millock, counsel Barbara Asheld and Long Island associate Brooke Lane.
  • Wearable Wellness
    HR Executive | October 1, 2014
    San Francisco Labor & Employment associate Alexandra Devendra is quoted in this feature story on personal health information confidentiality and HIPAA’s nondiscrimination provision concerning employee use of wearable devices.
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  • Lab I.T. Put to the Test
    Health Data Management | June 1, 2014
    Partner and leader of the firm’s Privacy & Data Protection practice Linn Freedman and Providence Government Investigations & White Collar Defense associate Kathryn Sylvia discuss provisions under a federal rule to give patients or designated representatives the right to receive copies of medical test results from most clinical laboratories.
  • Patients Get Direct Access to Lab Reports
    Clinical Laboratory News | April 1, 2014
    Partner and leader of the firm’s Privacy & Data Protection practice Linn Freedman discusses how labs should comply with patient requests for records under a new rule issued by the Department of Health and Human Services.

Ideas

21st Century Cures Act provides relief to qualifying hospitals with off-campus outpatient departments
Health Care Alert | January 3, 2017

Medicare updates address Section 603 of the Bipartisan Budget Act of 2015 and the NOTICE Act
Health Care Alert | December 15, 2016

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OIG releases new final rules related to the Anti-Kickback Statute and Civil Monetary Penalties Law
Health Care Alert | December 15, 2016

Webinar Recording: Graduate Medical Education Reimbursement
Originally recorded November 1, 2016 | November 14, 2016

CMS's CY2017 OPPS rule: payments for off-campus departments
Health Care Alert | November 7, 2016

Medicare's CY2017 rates and payment policies for hospital outpatient departments and ambulatory surgery centers
Health Care Alert | November 4, 2016

Regulators warn of FTC Act implications for deceptive HIPAA authorizations
Health Care Alert | October 31, 2016

MACRA Quality Payment Program Final Rule provides a more definitive path for transformed Medicare payments
Health Care Alert | October 18, 2016

OCR issues new guidance on HIPAA and cloud computing
Health Care Alert | October 12, 2016

New York updates hospital patients' bill of rights
Health Care Alert | September 1, 2016

OCR issues additional HIPAA audit guidance
Health Care Alert | August 3, 2016

What's trending on NP Privacy Partner
NP Privacy Partner | July 29, 2016

New York State cooling tower regulations move from "emergency" to "final"—with new requirements added
Environmental & Health Care Alert | July 20, 2016

OCR Releases HIPAA Guidance on Ransomware
Health Care Alert | July 15, 2016

Webinar Recording: Best Practices for HIPAA Compliance in 2016: Navigating the Landscape of Audits, Breaches, and Enforcement
Originally recorded on April 19, 2016 | April 21, 2016

What's trending on NP Privacy Partner
NP Privacy Partner | March 25, 2016

OCR announces start of Phase 2 HIPAA Audit Program
HIPAA Alert | March 22, 2016

NYS health commissioner uses discretion to issue blanket waiver to e-prescribing mandate in "exceptional circumstances"
Health Care Alert | March 18, 2016

New York State e-prescribing mandate effective March 27, 2016; no further delay is expected
Health Care Alert | March 2, 2016

Medicare Revalidations: Improvements and Cautions
Health Care Alert | February 26, 2016

Stark realities become more realistic: a sneak peek at CMS's final rule that is to be published in the Federal Register on November 16, 2015
Health Care Alert | November 4, 2015

NYS requires registration, inspection and testing of cooling towers state-wide by Wednesday, September 16, 2015
Health Care Alert | August 28, 2015

Breach of ePHI results in fine and corrective action plan for Massachusetts hospital
Health Care Alert | July 24, 2015

The New NPDB Guidebook brings changes for hospital and health care entity reporting of adverse clinical privileges actions
Health Care Alert | June 19, 2015

Physician compensation arrangements on OIG radar
Health Care Alert | June 11, 2015

ACOs—the leading model for care transformation
Health Care Alert | June 10, 2015

Proposed rules signal overhaul in fraud and abuse regulations governing Medicaid managed-care plans
Health Care Law Alert | June 1, 2015

Quality assurance requirements coming to NYS office-based surgery practices
Health Care Alert | May 20, 2015

NYS changes requirements for physician profiles
Health Care Alert | May 13, 2015

NYS Commissioner of Health granted new authority to appoint temporary operators of general hospitals
Health Care Alert | May 6, 2015

Amendment to New York's telehealth legislation
Health Care Alert | March 27, 2015

NYS Department of Financial Services (DFS) issues guidance on surprise bills for health care services
Health Care Alert | March 24, 2015

New York's Surprise Medical Bill Law: three things health care providers need to know before March 31
Health Care Alert | January 28, 2015

New York health insurers and state Medicaid program to cover telehealth services
Health Care Alert | January 5, 2015

Webinar Recording: Tech Talk 101: are you fluent in the language of data security?
Originally recorded October 8, 2014 | October 14, 2014

New York's e-prescribing mandate: Are prescribers and pharmacies ready?
Health Care Alert | September 11, 2014

What will New York's Medical Marijuana Law mean for employers?
Employment Law Alert | June 23, 2014

OIG updates guidance on charity patient assistance programs
Health Care Alert | June 5, 2014

Webinar Recording: The Release of Medicare Payment Data—What this New Level of Transparency Means for Providers and Industry
Originally recorded April 24, 2014 | April 24, 2014

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Compliance Counseling & Government Investigations