Compliance

Hooper, Lundy & Bookman has proven leadership and an unparalleled wealth of experience in the broad range of compliance issues health care providers face. We have assisted our clients with all stages of compliance, from preventative efforts such as developing policies, to responding to government enforcement action. We have represented our clients before virtually all government agencies that regulate providers. Our attorneys are well-versed in the implications of sweeping federal reforms affecting all aspects of health care provider operations and issues. We bring a perspective to compliance issues that has served our clients well for decades.

Medicare & Medicaid Compliance

Our nationally recognized expertise in the area of Medicare and Medicaid payment and coverage issues gives our clients a sound advantage when we advise them in defense of civil or criminal fraud and abuse audits and investigations, and in developing their internal compliance policies and procedures.

With nationally respected experience in this arena, our attorneys have defended health care facilities, organizations and individuals across the country in many landmark fraud and abuse cases in state and federal courts and in administrative hearings. Our lawyers have authored treatises on such topics as federal anti-kickback and physician self-referral (i.e., “Stark” law) issues.

We have negotiated global settlement agreements with various federal and state enforcement agencies and individual plaintiffs in whistleblower actions. Our efforts have led to precedent-setting court decisions favorable to the health care industry. Our attorneys have authored the comprehensive Hospital Compliance Manual, produced by the California Hospital Association.  In addition, our attorneys regularly participate in national programs and client education seminars, including the presentation of full-day compliance seminars for members of the CHA.

We have represented health care providers in hundreds of Recovery Audit Contractor (RAC) appeals, winning 98 percent of the appeals we have handled.

Our Multidisciplinary Defense Team

Our defense team includes attorneys who formerly held positions in the U.S. Department of Justice, the California Attorney General’s Office, and state Medicaid agencies. A number of our attorneys hold joint degrees in Health Care Administration, Public Health and Nursing, and have drafted national and state legislation and regulations. Consequently, we have full knowledge of the way government agencies develop and pursue their cases. This adds a critical perspective to our ability to successfully defend our clients.

Our fraud and abuse compliance specialists have been very successful in proving that many of the accusations by government agencies levied against health care providers as absolute violations of the law instead involve gray areas subject to good faith interpretation. We have also been successful in limiting agencies to their proper areas of jurisdiction and in narrowing the range of issues upon which an enforcement effort proceeds.

Preventing Problems Before They Arise

Our attorneys also provide the proactive representation required to head-off regulatory problems before they happen. We have extensive experience in drafting compliance plans, implementing compliance programs – including compliance training – and conducting internal audits and investigations. In addition, we are often asked to consult with respect to isolated fraud and abuse issues before any third-party inquiry has arisen.

Compliance Specialties:

• Antitrust
• Anti-kickback
• Copyright, patent infringement.
• Corporate integrity agreement negotiations
• Compliance program preparation, development, implementation
• Corporate Compliance/Governance (annual filings, out of state registrations etc.)
• Criminal and civil investigations and prosecutions
• False Claims Act defense
• FTC Regulations and Red Flag Rules
• Federal and state fraud and abuse allegations
• Hospital Operations
• Internal investigations
• Licensing
• Non-profit tax exempt entity compliance,
• Physician Dispensing of Drugs
• Pharmacy Regulation
• Privacy and security (HIPAA, CA privacy and security law, CAN-SPAM Act, COPPA)
• RAC appeals
• Sarbanes-Oxley
• Scope of practice
• Securities law, state & federal
• Self-referral analysis
• Stark and PORA compliance
• Trade secrets
• Voluntary disclosures to governmental agencies
• Workplace discrimination (ADA, Civil Rights law, sexual harassment, religious discrimination)