Phone: 302.658.4265
Health Law

Compliance Counseling

Health care providers are subject to a myriad of federal and state regulations, most notably federal and state fraud and abuse laws, Medicare and Medicaid participation conditions, state licensure requirements, patient privacy regulations, including HIPAA, and federal and state controlled substances regulations. Balick & Balick regularly assists health care providers of all types with understanding and complying with those specific regulations that affect their businesses.

Compliance Programs and Training

Balick & Balick counsels clients in all aspects of their compliance efforts, including designing, establishing and testing the effectiveness of compliance programs, policies, and procedures; drafting and updating compliance manuals; participating in compliance training; and fulfilling obligations under Corporate Integrity Agreements, including preparation of annual reports.

Internal Investigations

We are highly experienced in assisting clients in conducting internal investigations to determine compliance with company policies and procedures, including investigation of issues arising through the compliance communications process and internal billing and coding audits.

Contractual Arrangements

The firm structures and reviews providers’ contractual relationships with payors, professional employees, suppliers, vendors and other business partners to ensure compliance with federal and state laws and regulations implicated by these arrangements, including the Anti-Kickback and Stark statutes, HIPAA, state licensure laws, and state contract law.

Representative Matters:

Conducted annual internal billing/coding and documentation audits, with support of billing and coding experts, as part of regular compliance review for medical practices and individual providers.
Implemented corporate compliance programs for medical practices ranging in size from three to 50 employees.

Counseled a nursing home during a three-year Corporate Integrity Agreement with the Office of Inspector General to ensure compliance with the terms of the CIA, and assisted with the implementation of protocols recommended by OIG monitors.

Assisted numerous medical practices with crafting ownership structures and employment arrangements to ensure compliance with state and federal regulations, including self-referral and Anti-Kickback restrictions.

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