The continual influx of new laws and regulations and the rapidly changing healthcare environment present ongoing challenges for participants in the healthcare industry. Meeting the demands of this dynamic environment requires in-depth knowledge of complex legal issues as well as an understanding of our clients' business objectives. Moses & Singer's philosophy, in the representation of health industry clients, is one in which we pay attention to the needs of our clients, inform them of the boundaries of applicable regulations and develop comprehensive solutions so the clients' business needs are fulfilled in the most cost-effective and timely manner. Moses & Singer distinguishes itself from other health law practices through its responsive legal services, the business acumen of our attorneys and our ability to develop creative solutions to sophisticated legal problems. The attorneys in our healthcare practice group bring a unique perspective to the practice of healthcare law and the majority have previously held in-house positions in the legal departments of health care organizations or governmental agencies that address health issues.

Moses & Singer attorneys have extensive experience working with managed care organizations, financial institutions, not-for-profit healthcare systems, hospitals, academic medical centers, integrated delivery systems and physician practices that range from individual physicians to large, multi-specialty group practices and clinics. The Firm also represents IPAs, ancillary providers (including laboratories, pharmaceutical, radiology and others), physician and dental practice management companies, e-health companies, government entities, long-term and home health care entities, hospices and other forms of alternative delivery systems.

In order to provide healthcare clients with comprehensive counsel in a broad spectrum of matters, we frequently draw upon the expertise of Firm attorneys in other areas of practice including corporate, tax, litigation, bankruptcy, intellectual property and real estate. Moses & Singer has a broad-based healthcare practice, ranging from advising clients in transactional and regulatory matters to organizing a start-up venture or working closely with our clients to ensure compliance with health care anti-fraud, labor, OSHA, environmental, and other regulatory matters.

Moses & Singer attorneys actively assist healthcare industry clients in preparing healthcare provider, employment, and government contracts and we have assisted our clients in designing and implementing internal corporate compliance programs.

At Moses & Singer, our clients receive the first-class service and resources of a large law firm while maintaining the attentive relationships of a small firm. Partners work one-on-one with clients to ensure that all of their legal needs are met. In a highly competitive marketplace, Moses & Singer delivers cost-efficient service; by leveraging the experience we bring to projects, we are able to provide focused, high quality work at rates significantly lower than larger firms.

Managed Care

Moses & Singer's healthcare attorneys provide a wide range of services related to managed care arrangements. Our healthcare attorneys also represent organizations licensed to assume risk in the managed care context such as staff, group, and network model HMOs, Independent Practice Associations, Management Service Organizations, Physician Hospital Organizations, multi-specialty group practices, provider networks, and federal and state government programs. Our attorneys have broad expertise in structuring and negotiating related transactions for such organizations ranging from provider contracting with or for managed care entities, complex risk sharing arrangements and mergers and acquisitions.

Our familiarity with federal and state laws and regulations allows us to assist these entities in areas that range from counseling on fraud and abuse and self-referral issues to utilization review, and grievance and appeal issues. We regularly assist our clients in negotiations with regulatory agencies which oversee and have approval authority over transactions among these entities. Moses & Singer attorneys also have expertise with issues particular to Medicaid managed care and to Medicare + Choice, including the full range of contracting issues involving government regulatory agencies.

Institutional Providers

Moses & Singer serves as counsel for not-for-profit health care systems, academic medical centers, governmental health care providers and proprietary health care companies. We regularly provide advice on the legal, regulatory and corporate issues that arise from the various state and federal laws applicable to such entities. Our involvement extends from the revision of corporate and medical staff bylaws to enhance governance and efficiency, to the representation of academic medical centers with respect to such wide-ranging issues as informed consent, privacy issues, human subject research compliance and sponsored research agreements and grant administration in the research context.

Moses & Singer attorneys regularly assist clients in transactional matters including the creation and restructuring of healthcare corporations such as limited liability companies (LLCs), independent practice association (IPAs), and physician hospital organizations (PHOs), transitioning from not-for-profit to for-profit status, and transactions between entities such as mergers, acquisitions & divestitures of companies or partnership interests.

Our regulatory experience in the healthcare industry has enabled us to counsel our clients on a wide array of issues faced by institutional providers. Moses & Singer attorneys have counseled institutional providers such as hospitals, large mental healthcare organizations and New York City agencies on all aspects of Medicaid and Medicare reimbursement issues, federal and state regulatory requirements relating to the operation of programs to treat mentally ill, developmentally disabled or chemically dependent patients. Moses & Singer represents clients before state certificate of need authorities and before federal and state regulatory agencies on a wide spectrum of regulatory matters.

Fraud and Abuse

With increased government scrutiny of all healthcare arrangements to determine if they violate state or federal laws, healthcare organizations must be diligent in structuring and maintaining such arrangements. Our attorneys address this rapidly changing area of the law on a daily basis and are able to keep our clients abreast of changes that affect their operations and transactions. Our extensive knowledge of self-referral laws and regulations as well as federal and state anti-kickback provisions and related fraud requirements allows us to counsel our clients on all aspects of compliance. Our counsel includes structuring complex transactions in compliance with such requirements, structuring internal compliance programs, and assisting clients in qui tam actions, and advising on issues in the context of the False Claims Act.

Healthcare Privacy

Moses & Singer's healthcare practice has long been at the forefront of medical records privacy law. As part of our healthcare practice, we advise large healthcare entities, including e-health companies, providers, insurers, hospitals and academic medical centers, as well as financial institutions. We advise these entities on state and federal privacy laws related to the transfer of identifiable health information, the provision of healthcare, research (including human subject research) and the complex privacy issues that insurers, providers and employers face with regard to sensitive information held by them.

Attorneys in Moses & Singer's healthcare practice are nationally recognized for their focus on HIPAA Privacy Rules, having written and lectured on all facets of these particular regulations. We advise and assist our clients in performing audits of their privacy practices and in the development and implementation of their HIPAA Privacy Rule compliance plans. In addition, we have drafted a complete set of HIPAA Privacy Rule-compliant policies and procedures that are used by entities across the nation. The healthcare attorneys at Moses & Singer provide assistance to clients on all elements of the federal and state privacy laws, including issues related to drafting and customizing HIPAA Privacy Rule-compliant policies and procedures; identifying a client's business associates and negotiating business associate agreements; and drafting required authorization forms.

We also counsel clients on the interaction among the HIPAA Privacy Rule and other state, federal and international laws including state privacy laws and preemption issues regarding state law versus the HIPAA Privacy Rule, the Gramm-Leach-Bliley Act, the Family Educational Rights and Privacy Act, federal law regarding the protection of human research subjects; and the European Union's Data Protection Directive and Safe Harbor provisions.

Compliance

Moses & Singer attorneys understand that the purpose of compliance activities is to prevent, distinguish, and resolve conduct that does not comply with established regulatory requirements, or ethical or business policies. Our attorneys have developed compliance programs for healthcare entities of all sizes in order to address specialized issues regarding fraud and abuse, research, and recommended guidelines issued by the Inspector General of the U.S. Department of Health and Human Services.

We have extensive experience in formulating and building compliance programs in order to comply with state and federal laws, and internal ethics or code of conduct policies.

Services that Moses & Singer provide include drafting compliance plans, policies, procedures, and employee and management manuals. We also provide training, ongoing reviews and guidance addressing areas of noncompliance and corrective measures, and advice regarding compliance communication, such as reporting mailboxes, telephone or intra/internet helplines, and procedures to process anonymous reports.

Moses & Singer attorneys also assist clients with government investigations, enforcement actions, and inquiries by investigators or attorneys, and in response to litigation.

Pharmaceutical Industry

Moses & Singer has an in-depth knowledge of the many complicated issues that face today's pharmaceutical companies in the manufacture, marketing, and protection of products, as well as the issues faced by pharmaceutical entities in complying with the web of regulations and compliance guidelines applicable to them.

Attorneys at Moses & Singer have written and lectured frequently on research issues, including the effects of the HIPAA regulations, the interplay between HIPAA, FDA regulations and the Common Rule, and the role of IRBs in research compliance. Our attorneys advise clients on ongoing compliance with these issues, and possess the necessary expertise to assist in keeping pharmaceutical companies current in their understanding of the ever-changing legal landscape. Additionally, Moses & Singer attorneys help pharmaceutical companies develop clinical trials, and advise on issues related to research contracting and intellectual property.

Moses & Singer has also worked closely with various healthcare entities in developing compliance programs in order to comply with Compliance Program Guidance issued by the Office of Inspector general of the U.S. Department of Health and Human Services (OIG). Our attorneys have performed recommended risk analysis and developed strategies for corrective action, including the formulation and drafting of compliance plans, policies, procedures and training materials that comply with OIG recommendations.

Long-Term and Home Health Care

Moses & Singer attorneys have advised clients on a range of regulatory, transactional and real estate issues related to long-term care, home health, hospice and post-acute care. We counsel clients on Medicaid, Medicare and third-party reimbursement issues in this context, and on certificate of need requirements for such entities. Our transactional expertise includes, for example, structuring complex risk-sharing arrangements between payors and post-acute care facilities, transfer of ownership of long-term care facilities, and mergers and acquisitions. Our regulatory experience includes providing advice to our clients on compliance with federal and state fraud and abuse laws as well as issues related to oversight by state regulatory agencies.

Other Areas

In addition, working with other departments within Moses & Singer, we can provide our clients with in-depth experience in the following areas: Litigation, Bankruptcy, Intellectual Property, Tax and ERISA, and Real Estate.

For more information please email us at healthcareinfo@mosessinger.com

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