dcsimg Healthcare Regulation and Policy

Healthcare Regulation and Policy

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Government oversight affects every aspect of the healthcare industry, from construction of new healthcare facilities to payment for medical services. With multiple regulatory bodies governing healthcare at both the state and federal levels — often with overlapping authority — providers and insurers are left to juggle numerous, constantly changing regulations and policies.

The healthcare attorneys at McGuireWoods have the knowledge and experience that healthcare providers and insurers need to achieve compliance with federal and state-specific regulatory requirements. Our group of more than 60 healthcare-focused attorneys advises clients on a full range of regulatory and policy issues, including:

  • Federal and state anti-kickback and fraud and abuse laws
  • Federal and state self-referral laws, including the federal Stark law
  • Restrictions on patient transfers, including the federal Emergency Medical Treatment and Active Labor Act (EMTALA)
  • Health Care Quality Improvement Act
  • Patient consent issues
  • Death and end-of-life issues
  • Corporate practice of medicine restrictions
  • Medicare and Medicaid conditions of participation
  • Federal and state privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA)
  • False Claims Act
  • Food and Drug Administration (FDA) regulations
  • Employee Retirement Income Security Act (ERISA)
  • U.S. healthcare reform, including the Patient Protection and Affordable Care Act (PPACA)

We take full advantage of our firm’s national network of offices to represent clients in local, state and federal regulatory matters in jurisdictions throughout the United States. Given the rate of change and level of uncertainty in this highly regulated industry, we update our clients regularly on both national and local trends and pending legislation. We provide updates via frequent client alerts, help newsletters and blogs, including The Healthcare Investor.

CONTACTS

Melissa Gilmore Senior Counsel T: +1 202 857 1724
Stephanie A. Kennan Sr. VP, Federal Public Affairs
McGuireWoods Consulting LLC
T: +1 202 857 2922
Results 1-20 of 20
Representative Matter

Research and education foundation

Assisted research and education foundation in securing a multi-million dollar, multi-year grant from a medical device manufacturer to support clinical spine research and in developing a broader program to ensure industry compliance with the fraud and abuse laws in grant making.
Representative Matter

Nationwide wireless provider

Outside FDA regulatory counsel for a major nationwide wireless provider at the forefront of mobile health innovation, advocating for industry at FDA to bring the effectiveness and savings of mHealth to the U.S. market.
Representative Matter

Various clients

Assisted various clients in assessing the HIPAA and HITECH issues raised by the provision of mHealth services and in developing contractual and operational approaches to compliance.
Representative Matter

Client

Successfully prompted FDA to issue a Warning Letter based on submission of evidence that a competitor was making false and off-label promotional claims, resulting in diminution of competitor's stock value and providing a foundation for significant litigation to recoup damages.
Representative Matter

Lenders and investors

Represent lenders and investors in transactions with life science companies, performing high view and deep dive FDA due diligence to assess risks, benefits, and the need for fortified specialty agreements in such deals.
Case Study

McGuireWoods' Atlanta office assists client with certificate of need for home health

McGuireWoods recently assisted Duluth Medical Home Health with obtaining a Certificate of Need for a new home health agency dedicated to the Asian population. The State of Georgia recognized an exception under the general rules and criteria in granting the certificate.

Case Study

McGuireWoods secures certificate of need approval for Three Rivers Home Health-Treutlen

Three Rivers Home Health Services-Treutlen received certificate of need approval from the Georgia Department of Community Health, Division of Health Planning on March 24, 2009. With this approval, Three Rivers will be able to expand its home health service area to include nine additional counties in south Georgia. McGuireWoods partner Victor Moldovan and counsel Shay Bowen (both Health Care, Atlanta) represented Three Rivers in this victory.

Representative Matter

Major drug manufacturer

Assisted major drug manufacturer in negotiating with FDA, avoiding substantial product recall.
Representative Matter

Hospitals and surgery centers

Represented hospitals and surgery centers across the county in medical staff investigations, disciplinary matters, and hearings and in preparation of, and revisions to, medical staff bylaws.
Representative Matter

Healthcare providers, health plans, business associates and business associate subcontractors

Prepare and negotiate business associate agreements and business associate subcontracts for healthcare providers, health plans, business associates and business associate subcontractors.
Representative Matter

Pharmaceutical company

Effectively prompted FDA to issue a Warning Letter based on submission of evidence that a competitor was making false and off-label promotional claims, resulting in diminution of competitor's stock value and providing a foundation for significant litigation to recoup damages.
Representative Matter

New Virginia-based hospital

Provided Virginia certificate of public need advice for numerous projects over 24 years, including development of new $166 million, 126-bed new hospital.
Representative Matter

Major nationwide wireless provider

Outside FDA regulatory counsel for a major nationwide wireless provider at the forefront of mobile health innovation, advocating for industry at FDA to bring the effectiveness and savings of mHealth to the U.S. market.
Representative Matter

Major university

Advised major university in certificate of need approval, development, and operation of $135 million proton therapy institute.
Representative Matter

Various hospitals and surgery centers

Advised many hospitals and surgery centers regarding hospital-physician contracts.
Representative Matter

Various hospitals and surgery centers

Advised many hospitals and surgery centers regarding compliance and internal audit issues.
Representative Matter

Telecommunications company

Counseled on HIPAA security compliance, and drafted and revised security policies.
Representative Matter

Client

Assist clients with the implementation of HIPAA compliance programs, including preparing compliance plan documents, conducting training and assisting in the establishment of an infrastructure for monitoring and reporting.
Representative Matter

Client

Assess the application of HIPAA, the HITECH Act and the FTC breach notification rule to various telephony based products and services, including remote disease management, telephone answering services, medical paging services and personal emergency response services.
Representative Matter

Client

Regularly counsel clients regarding Medicare and Medicaid Anti-Kickback issues, Medicare coverage and payment issues, and HIPAA issues raised by the storage, receipt or transmission of patient health information.
Results 1-20 of 20
Results 1-25 of 33
Show All
Frank B Atkinson Frank B. Atkinson
Partner
One James Center
901 East Cary Street
Richmond, VA 23219-4030

T: +1 804 775 4376
F: +1 804 698 2226
vCard
Samuel C Bernstein Samuel C. Bernstein
Associate
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 849 8222
F: +1 312 698 4571
vCard
Meggan Michelle Bushee Meggan Michelle Bushee
Associate
201 North Tryon Street
Suite 3000
Charlotte, NC 28202-2146

T: +1 704 343 2360
F: +1 704 805 5085
vCard
Holly Carnell Holly Carnell
Associate
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 849 3687
F: +1 312 698 4504
vCard
Vincent A Dongarra Vincent A. Dongarra
Associate
One James Center
901 East Cary Street
Richmond, VA 23219-4030

T: +1 804 775 1049
F: +1 804 225 5404
vCard
Scott P Downing Scott P. Downing
Partner
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 750 8910
F: +1 312 920 6126
vCard
Amanda L Enyeart Amanda L. Enyeart
Associate
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 849 8106
F: +1 312 698 4523
vCard
Franklin E Freeman Jr. Franklin E. Freeman Jr.
Partner
434 Fayetteville Street
Suite 2600
Raleigh, NC 27601

T: +1 919 836 4003
F: +1 919 755 6699
vCard
Melissa Gilmore Melissa Gilmore
Senior Counsel
2001 K Street N.W.
Suite 400
Washington, DC 20006-1040

T: +1 202 857 1724
F: +1 202 828 3302
vCard
Jason S Greis Jason S. Greis
Associate
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 849 8217
F: +1 312 698 4550
vCard
D. Bowen Heath D. Bowen Heath
Counsel
434 Fayetteville Street
Suite 2600
Raleigh, NC 27601

T: +1 919 836 4009
F: +1 919 755 6699
vCard
Kimberly J Kannensohn Kimberly J. Kannensohn
Partner
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 750 8649
F: +1 312 920 3683
vCard
Harrison J Kaplan Harrison J. Kaplan
Partner
434 Fayetteville Street
Suite 2600
Raleigh, NC 27601

T: +1 919 836 4001
F: +1 919 836 4031
vCard
Christian Michael Kennedy Christian Michael Kennedy
Partner
434 Fayetteville Street
Suite 2600
Raleigh, NC 27601

T: +1 919 755 6673
F: +1 919 755 6598
vCard
Payal Keshvani Payal Keshvani
Associate
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 750 3616
F: +1 312 698 4558
vCard
Nathan A Kottkamp Nathan A. Kottkamp
Partner
One James Center
901 East Cary Street
Richmond, VA 23219-4030

T: +1 804 775 1092
F: +1 804 698 2072
vCard
LauraLee R Lawley LauraLee R. Lawley
Associate
201 North Tryon Street
Suite 3000
Charlotte, NC 28202-2146

T: +1 704 373 8997
F: +1 704 343 2300
vCard
Thomas Londrigan Thomas F. Londrigan Jr.
Partner
1 Old State Capital Plaza
Suite 410
Springfield, IL 62701

T: +1 217 527 1281
F: +1 217 527 1290
vCard
Drew E McCormick Drew E. McCormick
Associate
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 641 2084
F: +1 312 698 4501
vCard
Leigh B Middleditch Jr. Leigh B. Middleditch Jr.
Counsel
Court Square Building
310 Fourth Street, N.E.
Suite 300
Charlottesville, VA 22902-1288

T: +1 434 977 2543
F: +1 434 980 2267
vCard
Alison Vratil Mikula Alison Vratil Mikula
Counsel
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 750 8911
F: +1 312 698 4573
vCard
Elissa K Moore Elissa K. Moore
Counsel
201 North Tryon Street
Suite 3000
Charlotte, NC 28202-2146

T: +1 704 343 2218
F: +1 704 353 6164
vCard
David J Pivnick David J. Pivnick
Associate
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 750 3585
F: +1 312 698 4539
vCard
Robert J Pristave Robert J. Pristave
Counsel
77 West Wacker Drive
Suite 4100
Chicago, IL 60601-1818

T: +1 312 750 8616
F: +1 312 558 4376
vCard
Michael P Reynold Michael P. Reynold
Counsel
One James Center
901 East Cary Street
Richmond, VA 23219-4030

T: +1 804 775 1917
F: +1 804 775 1061
vCard
Results 1-9 of 9
Speaking Engagement

Benefits Law and Regulation: What More is Coming in 2013?

May 2, 2013
Bloomberg BNA Webinar
Event

Are You Still HIPAA Compliant?

Staying Protected in the Wake of the Omnibus Final Rule

March 27, 2013
HIPAA and the HITECH Final Rule Webinar Series
Event

Ambulatory Surgical Center Trends

Sales, Joint Ventures, Specialties, Turnarounds and Other Key Issues

March 21, 2013
Complimentary Teleconference
Event

Are You Still HIPAA Compliant?

Staying Protected in the Wake of the Omnibus Final Rule

March 19, 2013
HIPAA and the HITECH Final Rule Webinar Series
Event

Seven Emerging Issues in Stark, Kickback and False Claims Cases

March 6, 2013
Complimentary Webinar
Event

Investing in Urgent Care

Key Business and Legal Considerations

November 14, 2012
Complimentary Webinar
Results 1-9 of 9
Results 1-20 of 62
Show All
Legal Alert

Wake Up Call for Providers

Flurry of Settlements with Healthcare Facilities for Failures to Provide Auxiliary Aids to Disabled Individuals

April 25, 2013
Legal Alert

Key Reflections on the Healthcare Industry

Observations on 17 Niches and Specialties – A Dashboard Review; 7 Reasons to Worry About the Healthcare Economy; Specialty Physician Practice Trends; Is a Large Combined System Better?

April 23, 2013
Legal Alert

IRS Proposes Section 162(m) Regulations for Certain Health Insurance Issuers

McGuireWoods Healthcare Reform Guide: Installment No. 32

April 11, 2013
Legal Alert

Proposed Rules Issued on 90-Day Waiting Period Limitation for Health Benefits

McGuireWoods Healthcare Reform Guide: Installment No. 31

April 2, 2013
Article

HIPAA Compliance

5 Key Considerations for ASCs, Physician Practices and Small Providers

Becker’s ASC Review
March 2013
Legal Alert

DOL Issues Final Rules on MEWA Reporting and Enforcement under Healthcare Reform

McGuireWoods Healthcare Reform Guide: Installment No. 30

March 21, 2013
Legal Alert

22 Advisory Opinions Issued by the Office of Inspector General (OIG)

Six of Interest; Anesthesia ASC Arrangements – Seven Key Concepts; and ASC Anti-Kickback Safe Harbor Issues Nine Key Concepts for 2013

February 19, 2013
Results 1-20 of 62