Austin Lawyers For hospitals health systems
Business issues plaguing hospitals and health systems in today’s environment are extremely complex. While balancing the needs of patients and staff, administrators must also deal with the uncertainty of an increase in demand for medical services and the decrease of federal and state funding to cover the costs.
The dependency on Medicare and Medicaid leads to never-ending disputes between serviced rendered and the interpretation of government regulations. Notwithstanding negotiating and enforcing managed care contracts require a knowledge level of how much services costs and what is involved in managed care and healthcare contracting.
Add on the fact that professional and institutional bodies for licensure and accreditation have become increasing vigilant, and it is quite clear that patients are not the only entity keeping the health service providers busy.
Ways Legal Issues are Clashing with Hospitals and Health Systems
Concerns about Stark law violations, kickbacks, and fraud and abuse have financial managers at these institutions thinking about remaining compliant while expanding services. Changes to policies and procedures have joined plans to merge and create joint ventures. HIPAA regulations and issues with homeland security demand that hospitals and health systems implement major changes.
Legislation that Regulates Healthcare
As one of the most heavily regulated U.S. industries, no state or federal healthcare law gets passed without interpretive regulations. This includes the Patient Protection and Affordable Healthcare Act (ACA) that has volumes of regulations that providers must interpret.
Other laws that serve to regulate the industry include:
• Stark Law
• Anti-Kickback Statute
• False Claims Act
• Civil Monetary Penalties Law
In addition, hospitals and health systems must be careful to follow medical practice structure, state licensing, anti-referral and fraud laws.
Litigation and Alternative Dispute Resolution
Whether a hospital or health system is the defendant in a legal action or has filed its own lawsuit, all types of cases have become a regular part of daily activities. A suit may come from a patient, payer, management company, distributor or another healthcare provider. This requires being vigilant and up-to-date on litigation and arbitration.
Healthcare attorneys can provide legal representation for all types of disputes at the state and federal levels. These include:
• Patient disputes
• Tort actions
• Reimbursement issues
• Court actions over Medicare and/or Medicaid regulations
• Arbitration between doctors and hospitals
• Licensure and credentialing matters
Research and Clinical Trials
Research and clinical trials are of paramount importance. Specialized hospitals for treatment of cancer, children’s health issues and surgery are strengthened by the ability to conduct research for medical breakthroughs. Whether it is for the development of a new drug or medical device, this is one area of medicine that is strongly needed, yet could cause legal troubles for a healthcare institution.
Healthcare Attorneys Will Handle Legal Issues for Providers
Healthcare professionals need a watchful partner who not only can carry them through a tough legal action, but who can also help providers avoid a lawsuit. Serious legal issues that threaten the existence of a medical facility can be unnerving.
Patients miss out on optimal care because providers can become distracted by a pending outcome. Hiring an experienced healthcare attorney can alleviate those worries.