We assist home
healthcare providers with a range of business, regulatory, and strategic
challenges, including:
Business
Transactions
- Formation of entities
and business structure
- Purchase and Sale
Agreements
- Agreements with
wholesalers and other suppliers
- Employment and
independent contractor agreements
- Medicare
competitive bidding applications
Regulatory
Defense
- Reimbursement audits
by private and governmental payors and their contractors, including Medicare,
Medi-Cal, and Palmetto GBA.
- Fraud and abuse
investigations by government payors and their contractors, including Safeguard
Services, Office of Inspector General, Federal Bureau of Investigations,
Department of Justice, Department of Health Care Services, and Bureau of Medi-Cal Fraud and Elder Abuse
- Zone Program
Integrity Contractor (“ZPIC”) audits, Recovery Audit Contractor (“RAC”) audits,
and Program Integrity Safeguard (“PSC”) audits.
Compliance
- Licensing,
operational, and reimbursement compliance
- Medicare and Medi-Cal
enrollment and changes of ownership
- HIPAA and state
patient data privacy and security requirements
- Prepayment review
corrective action plans
- Documentation
solutions for establishing medical necessity
- Marketing practices
and business development compliance
Litigation
- Medicare enrollment
and claim denial appeals
- Medicare and Medi-Cal
overpayment appeals involving power wheelchairs, electric hospital beds,
infusion drugs and supplies, and various braces and orthotics
- Exclusion and
suspension appeals by government entities, including the Department of Health
and Human Services Office of the Inspector General and California Department of
Health Care Services
- False Claims Act
civil defense
- General business
litigation