Health care providers are subject to rigorous scrutiny of their compliance with applicable state and federal laws and regulations. As the civil and criminal penalties for noncompliance increase, so does the need for an effective corporate compliance plan to help the organization maintain compliance. For nursing facility providers, the development of an effective corporate compliance plan has now been mandated by federal law. Our attorneys have assisted numerous providers in developing and implementing corporate compliance plans and have aided providers in institutionalizing these plans, including providing training on the plan and compliance issues to staff, senior management, and Boards of Directors.
Our attorneys are well-versed in current fraud and abuse issues and are regular lecturers on these subjects. We routinely assist providers in evaluating business relationships with vendors and referral sources for compliance with applicable law. We also regularly assist providers in conducting self-audits, often working closely with consultants to guide these reviews within the scope of attorney-client privilege. We have the ability to interface with federal and state regulators, and we have been instrumental in resolving disputes involving compliance matters before the Pennsylvania Medicaid Fraud Control Unit (MFCU) of the Attorney General's Office, federal fiscal intermediaries and carriers, and governmental agencies. We have successfully navigated clients through the challenges of self-disclosure, including reporting and repaying discovered overpayments.