Health Care Law
The evolution of complex Federal and State health care statutes, greater governmental and private insurance company scrutiny of provider billing, and deeper cuts in physician reimbursement rates, coupled with steadfast corporate, tax and public health laws, to name a few, has made the “business” of running a medical practice more challenging than ever before. Martin Clearwater & Bell LLP attorneys partner with their clients to navigate them through the morass of legal requirements and regulations facing hospitals, physician practices and other health care providers. The Firm believes that risk prevention and control are valuable investments for its clients. MCB assists health care practices to proactively identify systemic problems and potential areas of liability, develop and implement corrective strategies, and establish effective policies and protocols for future compliance to enhance the quality of care and limit exposure.
Members of the Firm have served as hospital board members, Chairs of Boards of Quality Assurance Committees, Chair of the New York State Bar Committee on Physician Discipline and Member of the American Bar Association Subcommittee on Professional Liability.
Areas of concentration include:
• Comprehensive reviews and analysis of medical practices for compliance
with Federal and State laws and regulations
• Health care fraud and abuse investigations and proceedings
• Medicare, Medicaid and commercial insurance billing audits
• OPMC and DOH interviews, investigations and disciplinary actions
• Physician and medical staff investigations and discipline
• Risk management education presentations
• Response to regulatory citations and criminal investigations of hospitals
• Pre-litigation investigations
• Structuring of physician practice groups
• Preparation of agreements on behalf of group practices and individual physicians
MCB Result: Audit representation.
MCB attorneys successfully represented a physician practice in an audit brought by the New York State Office of Medicaid Inspector General (OMIG) involving alleged overpayments secondary to the improper submission of claims for services provided to dual Medicare/Medicaid eligible patients between 2005 through 2008, resulted in a 30% reduction of the amount originally demanded, without the imposition of any interest or penalties.