What is the role of a healthcare attorney in advising healthcare providers on compliance with federal and state healthcare laws and regulations?

As a healthcare attorney, one primary role is to advise healthcare providers on compliance with federal and state healthcare laws and regulations. This responsibility involves ensuring that their clients are in compliance with the various regulations governing their operations, including but not limited to the following:

• HIPAA - The Health Insurance Portability and Accountability Act (HIPAA) governs the privacy and security of patients' health information. The role of a healthcare attorney includes ensuring that their clients are compliant with HIPAA regulations. This includes educating healthcare providers on HIPAA policies, assessing their compliance, and providing advice on how to improve their policies to meet federal HIPAA requirements.
• Medicare and Medicaid - The Centers for Medicare and Medicaid Services (CMS) regulates Medicare and Medicaid programs, and healthcare providers are expected to comply with these regulations. Healthcare attorneys can advise healthcare providers on compliance with these laws, including rules around billing for services, reimbursement requirements, and Medicaid fraud laws.
• Stark Law and the Anti-Kickback Statute - These laws are federal laws governing the relationships between healthcare providers and entities such as referral sources, vendors, and other own businesses. Healthcare attorneys can advise providers on contracts or other arrangements that implicate these laws, so as to ensure compliance.
• State Healthcare Laws - State laws often supplement federal healthcare laws, and healthcare attorneys help their clients understand or address any state-specific policies.

In advising healthcare providers on compliance with these laws and regulations, the role of the healthcare attorney includes conducting compliance audits, reviewing policies and procedures, providing training to employees, implementing compliance measures, mitigating risk, handling reported violations, discussions with government enforcement officials, and pre-litigation assessments and opinions.

It's essential to note that the above is not an exhaustive list of healthcare laws and regulations healthcare providers must comply with, and healthcare attorneys will need to stay up to date with ever-changing regulations and case law. Healthcare attorneys will need to be knowledgeable in various areas of healthcare law and provide clients with comprehensive legal advice that takes into account the specific details and unique circumstances of their situation.

If healthcare providers do violate healthcare laws and regulations or face government investigations, healthcare attorneys can assist in mitigating any damages, penalties, or consequences that may have ensued from noncompliance. Healthcare attorneys will advise the providers on the best way to comply with the government's request, cooperate with investigators, and demonstrate the provider's good intentions in a proactive way.

If a provider anticipates entering into a legal arrangement with the risk of noncompliance, obtaining a legal opinion to determine whether the transaction is compliant with healthcare laws is best practice.

In conclusion, healthcare attorneys maintain a vital role in ensuring regulatory compliance for healthcare providers, and their responsibilities provide an essential service that is important in the healthcare industry.