Healthcare Compliance, Regulatory, & Reimbursement Services - Expertisience
Healthcare is complicated. As you would expect, the system the government has set up to pay for healthcare and regulate providers is too. According to one frustrated federal judge, the Medicare Act is an “impenetrable thicket” of complexity and cross-reference. And that ignores the immense volume of regulations and guidance regularly issued interpreting this mind-boggling law.
Of course, there are many other federal statutes and regulations and also voluminous state laws and rules that healthcare providers must follow. Compliance is not optional, and is enforced by government agencies - and by private individuals in suits under the False Claims Act.
When dealing with this level of complexity, expertise interpreting healthcare law and rules is key – and so is long years of experience seeing and dealing with changes in the law. It is not enough simply to understand the rules – meaningful compliance and defense strategies require knowing how healthcare operations actually work, so that an advisor can clearly communicate obligations and evaluate whether those are met. A trial lawyer friend calls this combination "expertisience."
I began to practice healthcare law in 1985, when Medicare had been around for only twenty years. To be sure, Medicare and Medicaid and other federal healthcare laws change frequently – healthcare spending in America hovers around 20% of GDP, and more than a third of that comes from these two programs alone. With that many tax dollars involved, Congress no doubt will continue with frequent and sometimes major amendments.
If you are struggling with a legal issue in healthcare, let’s have a conversation. I would love to use my experience to help you.