Governmental systems and rules are firmly ingrained in California’s health care system. We regularly help providers navigate these complex systems, including the specific rules related to Medicare and Medi-Cal (in both “traditional” and “managed care” contexts). Our work in this area includes representing providers in administrative appeals, as well as managed care and life sciences organizations in contract negotiations with the government.
We also regularly advise public entities with respect to the unique laws that apply to them (e.g., the Brown Act in California). Public healthcare institutions are often governed by state and federal statutory and constitutional law. We know how to spot risks, and if appropriate, rely on these laws to get the best result for our clients.
Corporate Practice of Medicine
California is one of many states that enforces prohibitions against lay corporations employing physicians. We are thoroughly conversant with this law, its many applications and exceptions. Appreciation of the law is critical in structuring sales, mergers and management agreements between physician groups and lay entities such as hospitals and MSOs. We keep clients up to date on the modern devices used to navigate these laws, including “Friendly P.C.” structures.
Fraud and Abuse Laws
We regularly advise our clients in negotiating the often confusing and sometimes conflicting laws and regulations which govern the formation and operation of many types of healthcare ventures, including imaging centers, ambulatory surgery centers, medical office buildings, and similar business structures. We are experts on the various fraud and abuse laws, including the federal and state anti-kickback laws, the Stark law, Speier law, and False Claims Act.
We help our clients navigate the thicket of privacy laws from varying jurisdictions, including HIPAA, California’s CMIA, CCPA, and CPRA, and the European Union’s GDPR.