The phrase “Health Care Law” is a broad term that encompasses a full spectrum of topics that are often referred to as “health care.” To the service providers, which includes hospitals, nursing homes, assisted living facilities, medical and dental practices, community and mental health centers, home health agencies, imaging centers, and physical and occupational health providers, among others, “Health Care Law” is an amorphous term and very challenging.
The regulations that must be complied with in terms of privacy, fraud and abuse and electronic medical records have become a minefield to everyone that steps into this industry, while at the same time, the providers must focus on patient care and the delivery of quality care.
At first glance one would think that the regulations only deal with compliance and penalties; however, many of the rules and protocols are designed to assist health care service providers with billing and reimbursement methodologies so as to ensure that they are paid timely and fairly for the service that is provided.
It is important to note that many of the laws governing compliance do not require the health care service provider to have actual knowledge or a specific intent to violate the law. Providers should also be aware of the many federal and state programs, grants and tax credits that are available to them and buried within the more than 1,000 pages of the Patient Protection and Affordable Care Act.
It is difficult, if not impossible, for the provider to excel at patient care and navigate compliance without the assistance of consultants and legal professionals because the regulations are truly a minefield. The provider must concentrate on delivering quality services while at the same time staying out of “harms way” and maximizing reimbursement potential!
PLDO’s Health Care Practice Team includes well respected practitioners with experience in providing guidance to providers in dealing with the challenges that they confront each day. Our lawyers routinely conduct a compliance assessment of the provider’s practice in an effort to determine what is required to maintain compliance and improve quality. We work with experts in the field to develop and implement “best practices” for the staff and monitor recommendations aimed at preventing and correcting compliance concerns. Additionally, if a health care service provider finds him or herself as the subject of a regulator’s audit or investigation, PLDO has experienced lawyers who will represent and defend allegations of non-compliance, fraud and abuse. If you have questions about health care regulations and compliance issues and would like to speak to a member of our Health Care Practice Team, please call Attorney Jillian Jagling at 401-824-5100 or email We welcome your comments, questions and suggestions.