Houston Health Care Regulatory Compliance

Navigating a Complex Regulatory System in Texas

Health care is arguably the most stringently regulated industry in the United States. Whether you are pursuing a health care business transaction, executing a contract, or establishing a risk-mitigating structure for your practice, you must ensure you meet strict regulations. Regulatory compliance is crucial because failing to do so can create exposure to audits, investigations, and serious penalties that jeopardize the success of your business and professional future.

At Hendershot Cowart P.C., our Houston-based health care regulatory compliance lawyers have decades of experience counseling health care professionals and practices across the country in a range of state and federal regulatory compliance matters, including those related to the False Claims Act, Anti-Kickback Statute, Stark Law, and more.

Schedule a consultation with our Houston health care regulatory compliance attorneys when you call (713) 909-7323.

Comprehensive Regulatory Compliance Services

With more than 100 years of collective experience, our legal team has the insight and resources to help clients in a range of regulatory matters, including:

  • Proactive counsel and support
  • Drafting and implementing compliance plans
  • Health care transactions and start-ups
  • Medicare provider enrollment
  • Responsive representation for audits, investigations, and alleged violations.

In all of our work, we focus on preparedness – from ensuring that your health care business transaction is structured properly to ensuring that your practice stands up to the increasing scrutiny of state and federal regulators. Our services are utilized by providers throughout the U.S.

Compliance in Health Care Transactions and Startups

Numerous regulatory requirements govern transactions and business dealings involving health care professionals and facilities. The Stark Law, fraud and abuse statutes, False Claims Act, anti-kickback laws, and other regulations all affect which parties can be involved in a transaction and how the transaction should be structured.

We Regularly Handle Transactional Matters Involving:

  • Joint ventures
  • Establishment, purchase or sale of compounding pharmacies
  • Investments by physicians
  • Purchase of equipment and lease agreements
  • Management agreements
  • Billing arrangements

Drafting and Implementing Healthcare Compliance Plans

A sound compliance program is the best preventative medicine for any health care organization. Health care providers are under increased scrutiny from the Texas Attorney General, the Department of Health and Human Services' Office of Inspector General (OIG), Texas Department of Insurance (TDI), and other government agencies. Even if you did not intend to commit a violation, you can face costly and time-consuming investigations, sanctions, penalties, and even criminal prosecution.

A comprehensive properly implemented compliance plan provides clear direction to members at every level of the organization and minimizes the potential for you to be the target of an investigation.

Our health and medical law team develops individualized compliance programs for clients in an array of different health care settings, including medical practices, clinics, suppliers, and hospitals.

We Address All Issues Relevant To Your Organization, With a Focus On:

  • Written policies, procedures, and standards of conduct
  • Compliance officers, compliance committee, and oversight
  • Effective training and education
  • Effective lines of communication
  • Well-publicized disciplinary standards
  • Effective system for monitoring, auditing and identification of compliance risk
  • Enforcement plan and procedures and systems for prompt response to compliance issues
  • Operative corrective action plan
  • Health Insurance Portability and Accountability Act (HIPAA) compliance, patient confidentiality, and solicitation regulations, and self-referral and anti-kickback laws

The Importance of Oversight in an Effective Healthcare Regulatory Plan

There needs to be some form of accountability as well as someone who oversees how records are being processed. Appointing a compliance officer to handle these things is highly recommended.

Your compliance officer should know the system in and out, and be able to effectively train new employees on the subject of how to follow protocols. They should also audit records and hold regular reviews of files to ensure that your employees are adhering to protocols and take measures to help iron out any problems that arise, either through retraining employees, making changes to outdated protocols, etc.

Audit & Monitor your Compliance Plan to Avoid Regulatory Investigations

We strongly encourage clients to actively audit and monitor healthcare compliance plans to ensure compliance on an ongoing basis. A thorough medical practice compliance plan should:

  • Outline general audit guidelines, including procedures for reviewing compliance with coding, billing, and documentation requirements, on a concurrent (prior to submission) and / or retrospective (after submission) basis
  • Prioritize federal programs when conducting audits and monitoring, and stay up to date with any changes in claims submission, OIG updates, and compliance guidelines.
  • Compare audit results with benchmark data
  • Establish guidelines to foster collaboration between at least one medically trained individual (i.e. nurse or physician) and administrative personnel
  • Conduct audits at least once per year, and review at least five or more medical records per federal payer, and five to 10 medical records per physician

Speak With a Texas Health Care Regulatory Compliance Lawyer Today

As a law firm that has earned national recognition for our work in health care and medical law and the representation of providers facing audits, investigations, and allegations of waste, fraud, and abuse, Hendershot Cowart P.C., has the requisite experience and resources to help all types of medical practices establish the clear and enforceable compliance plans that allow them to effectively operate their practices, ensure compliance, and avoid risks of litigation or penalties that can jeopardize their futures.

From tailoring compliance programs to the unique needs of practices to addressing critical issues and compliance with important federal health care regulations like the Anti-Kickback Statute, Stark Law, and False Claims Act, and other Texas health care fraud laws, our team focuses on a comprehensive approach to compliance, and to the proactive measures that ensure providers establish the policies and best practices for implementing their plans moving forward.

Our Houston-based attorneys at Hendershot Cowart P.C. proudly serve clients throughout Texas and the U.S.

Call (713) 909-7323 to arrange an initial consultation with a member of firm, or fill out an online form to get started.

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