As the healthcare industry continues to evolve, more government agencies and payors are looking to reduce home healthcare costs. Growing technological support coupled with new regulations have fueled more interest in caring for patients within the comfort of their homes.
New models for patient care, as well as increased consumer demand have contributed to change within the competitive landscape. New challenges and opportunities for home health agencies continue to evolve as these organizations work with healthcare providers to extend patient care in alternative care settings.
Our attorneys have a depth of experience across a full spectrum of alternative care issues, offering home health agencies regulatory oversight and strategic vision to accomplish their business goals.
- Defended Zone Program Integrity Contractor (“ZPIC”), Recovery Audit Contractor (“RAC”), and Program Integrity Safeguard (“PSC”) in home health agency audits
- Advised a L.A.-based home health agency regarding a full range of business needs, including entity formation, business structure, purchase and sale agreements, professional, executive, payor, and vendor contracts, and service, employment and independent contractor agreements
- Handled licensing, operational and reimbursement compliance, Medicare and Medi-Cal enrollment, corrective action plans, and other compliance strategies for a home health agency
- Advised on HIPAA and state patient data privacy and security requirements for a large home health agency
- Handled a home health agency’s compliance for marketing and business development activities, as well as qui tam whistle-blower litigation defense
- Represented several home health agencies in government payor and contractor investigations by organizations, including Safeguard Services, Office of Inspector General (OIG), Federal Bureau of Investigations (FBI), Department of Justice (DoJ), California Department of Health Care Services (CDHS), Bureau of Medi-Cal Fraud, and Elder Abuse
- Defended several home health agencies in litigation matters, including licensure defense, payor and reimbursement disputes, overpayment appeals, business and employment defense, Medicare and Medi-Cal exclusions, and suspensions by government entities including Centers for Medicare & Medicaid Services (CMS), OIG, and CDHS
- Represented several home health agencies in Department of Public Health (DPH) licensure investigations and appeals