Clay J. Countryman

Clay J. Countryman: Attorney with Breazeale, Sachse & Wilson, L.L.P. AV stamp icon
Attorney Awards

Biography

Clay Countryman is a partner in the health care group in the Baton Rouge office of Breazeale, Sachse & Wilson, L.L.P. Mr. Countryman represents clients in all areas of the health care industry, with a focus on health care corporate transactions, fraud and abuse compliance, development of health care provider networks and alternative health care payment approaches.

Clay has primarily served as legal counsel to several different types of health care providers and provider organizations, ranging from national and regional hospital systems, physician organizations, specialty physician groups, clinically integrated networks, physician-owned hospitals, diagnostic imaging facilities, ambulatory surgical centers, pharmacies, health care management companies, and health care trade associations.

Clay is an active member of several health care associations and other organizations. Clay has been an active member of the American Bar Association for over 20 years, including several leadership positions in the Health Law Section, the ABA Veterans Legal Services Commission, Medical-Legal Partnerships and the ABA Young Lawyers Division.

Health Care Corporate Transactions

Clay has assisted health care providers in structuring joint ventures and other transaction to promote business objectives while meeting compliance requirements of specific health care laws and regulations, such as the Stark Law, the Federal Anti-Kickback Statute, Medicare and Medicaid coverage and reimbursement requirements, and licensure and accreditation requirements.

•Formation of Joint Ventures to Develop and Operate Hospitals and Other Health Care Facilities
•Mergers and Acquisitions of health care providers
•Development of health care provider networks, Accountable Care Organizations (ACOs), and Clinically Integrated Networks
•Employment Agreements, Professional Service Agreements, Medical Director and Recruitment Agreements
•Conducted Due Diligence in Acquisitions and Financing

Fraud and Abuse Compliance

Clay has extensive experience in counseling clients on compliance with the Federal Anti-Kickback Law, the Stark Physician Self-Referral Law, and the federal Civil Monetary Penal Law and regulations.

•Stark Law and Anti-Kickback Statute Compliance in Structuring Transactions
•Development of Co-Management Agreements and Gainsharing Arrangements
•Implemented and Reviewed Corporate Compliance Programs
•Government Investigations and False Claims Act Defense
•Advised Health Care Providers on Voluntary Self-Disclosures and Refunds

Community Involvement

Board of Directors, St. Vincent de Paul

Open Air Ministries, Board Member

Baton Rouge Area Chamber Leadership Program, Class of 2015

St. Joseph’s Academy, President Dad’s Club 2014/2015

Council for a Better Louisiana (CABL) Leadership Louisiana (2016)

Honors and Awards

AV Preeminent Peer Review Rated.

Ranked in Chambers USA: America's Leading Lawyers for Business for Louisiana in the area of Healthcare in 2017

Publications

•“Florida Hospitalist Group Pays $500,000 to Settle Potential HIPAA Violations ” December 2018
•“DOJ Announces Settlement with Physicians Based on Pre-Signed Blank Prescriptions for Controlled Substances ” August 2018
•“CMS Requests Feedback on Regulatory Burden of the Stark Law ” June 2018
•“Justice Department Files Brief in Texas Lawsuit Supporting Challenge to the Constitutionality of the ACA ” June 2018
•“Compliance Risk for Physician Practices in Waiving Patient Copays and Deductibles ” The Link, LAMMICO Newsletter, Volume 37, Number 2, Second Quarter 2018, May 2018
•“HIPAA and Business Associate Agreements: Slippery Slopes for Attorneys ” The Baton Rouge Lawyer, Volume 1, Issue 3, p. 18-20, May 2018
•“Family Medicine Centers of South Carolina Paid $2 Million to Settle Alleged Stark Law Violations Based on Internal Physician Compensation Approach ” September 2017
•“Emerging Compliance Issue: Recent False Claims Act Settlements Based on Improper Billing for Evaluation and Management Services by Physicians ” August 2017
•“IRS Revokes Hospital’s Nonprofit Status for Failure to Meet the Community Needs Assessment Requirements Under Internal Revenue Code Section 501(r) ” August 2017
•“OIG Announces August 2017 Work Plan Updates ” August 2017
•“Compliance Risk for Physician Practices in Waiving Patient Copays and Deductibles ” August 2017
•“eClinicalWorks Case Raises New Questions ” June 2017
•“OCR Settles First Enforcement Action for Untimely Reporting of a Breach ” February 2017
•“OIG Finalizes New Anti-Kickback Statute Safe Harbors and CMP Authorities ” Louisiana Hospital Association's Impact Law Brief, January 2017
•“Final Rule Released to the OIGs Exclusion Authorities ” January 2017
•“OCR Phase 2 HIPAA Audits Have Begun: Are you Ready? ” September 2016
•“Anesthesia Group Settles Kickback Allegations to Obtain Exclusive Agreements With Ambulatory Surgery Centers ” August 2016
•“OIG Corporate Integrity Agreements and Physician Compliance Programs ” June 2016
•“'Cloning’ and 'Overpopulation’ of Documentation by Physicians in Electronic Medical Records May Lead to Allegations of Fraud ” June 2016
•“Physician Practice and Hospital Pay $750,000 and $1.5 Million for Failure to Have HIPAA Business Associate Agreements ” May 2016
•“OCR Settlement with Physician Group Highlights Need For HIPAA Business Associate Agreements ” April 2016
•“Imported Drugs and Medical Devices: Physicians Face Significant Liability for Purchasing Imported Drugs and Medical Devices ” April 2016
•“Challenges to Medicare Advantage Plans Passing Sequestration Cuts Through to Contracted Providers ” April 2016
•“OCR Announces $1.55 Million Settlement Based on Failure to Have a Business Associate Agreement in Place and Conduct an Organization-Wide Risk Analysis ” March 2016
•“2016 Hot Compliance Areas for Physician Practices ” March 2016
•“Hot Off the Presses! CMS Issues Final Overpayment Regulations ” February 2016
•“Recent False Claims Act Settlements Based on Hospital-Physician Compensation Arrangements ” January 2016
•“Recent False Claims Act Settlements Based on Allegations of Improper and Excessive Hospital-Physician Compensation ” December 2015
•“OIG Issues Advisory Opinion on Charitable Organization Providing Financial Support for Patients ” 12/1/2015
•“CMS Issues Proposed Stark Law Changes in the Proposed 2016 Medicare Physician Fee Schedule ” August 2015
•“Recent False Claims Act Case Involving Hospitalists’ Services Includes Allegations that Company’s Compliance Program and Corporate Officers Had Knowledge of Upcoding ” July 2014
•“Non-Profit Health Care System Agrees to $800,000 HIPAA Settlement in Medical Records Dumping Case ” June 2014
•“Federal Court Rules that Hospital Violated the Stark Law in Compensation Arrangement with Employed Physicians ” LHA Impact, November 2013
•“OIG Issues Advisory Opinion 13-09 on Ownership Interests in Group Purchasing Organization By Hospital and Other Providers ” August 2013
•“BSW Health Law Blog ” August 2013
•“Health Care Reform Update: White House Extends Employer Coverage Mandate to 2015 ” July 2013
•“OIG Issues Warning to Hospitals and Other Providers In Special Fraud Alert on Physician-Owned Distributorships for Implantable Medical Devices ” April 2013
•“OCR Finalizes Provisions to the HIPAA Enforcement Rule in the HIPAA Megarule To Address Liability and Civil Money Penalties for HIPAA Violations ” ABA Health eSource, January 2013
•“Federal Appeals Court Overturns $45 Million Judgment Against Hospital Based On Stark Law Violations ” Louisiana Hospital Association Impact Monthly Newsletter, April 2012
•“Claims Data Sharing and HIPAA Privacy Compliance: Key Components for ACOs and Other Provider Networks ” Louisiana Hospital Association Impact Monthly Newsletter, February 2012
•“OIG Issues Favorable Opinion on Online Medical Information Sharing and Referral Database Service ” Louisiana Hospital Association Impact Monthly Newsletter, January 2012
•“OIG Issues Favorable Advisory Opinion on Neurology Telemedicine Arrangement ” Louisiana Hospital Association Impact Monthly Newsletter, September 2011
•Author of Chapter on Entrepreneurial Medicine: Fraud and Abuse Risk Areas For Physician Business Relationships in Physician Law, Evolving Trends and Hot Topics by ABA Publishing (2014 and 2015)
• CMS Addresses Data Sharing and HIPAA Privacy Compliance in the Final ACO Rule, ABA Health eSource, ACO Special Edition (December 8, 2011)
•Health Care Controllers Manual, Contributing Author, Thomson Reuters Publishing (2009)
• Managed Care Litigation Cumulative Supplement, Contributing Author, BNA (2009)
• Managed Care Litigation Book, Prompt Pay Litigation and Related Issues and Federal Benefit Claims Procedures (affecting ERISA plans), Contributing Author, published by BNA (September 2005)
• HIPAA Compliance Handbook, Aspen Publishing (March 2001)
• Physician Practice Compliance Resource Manual, Aspen Publishing (January 2001)

Presentations

Fair Market Value Issues: When and How is FMV Important; Valuation Issues and Options, Louisiana Hospital Association Advanced Issues in Physician Employment Seminar, April 2019
Understanding the Applicable Compliance Issues, Louisiana Hospital Association Advanced Issues in Physician Employment Seminar, April 2019
Payment Issues in Behavioral Health, LHA Behavioral Health Law Update, March 2019
Payment Issues in Behavioral Health: Options for Providers, Louisiana Hospital Association Behavioral Health Law Update, March 28, 2019
Navigating the Minefields of a Successful Physician Hospital Collaboration, ABA Physicians Legal Issues Conference, June 7, 2018
Physician Contracts: Compliance Auditing & Strategies, CHRISTUS Health Compliance & Privacy Summit, May 2, 2018
Measuring Compliance Program Effectiveness, HCAA New Orleans, April 2018
Healthcare Enforcement and Radiology Services, 2018 PaRaDigm Conference - Radiology Business Managers Association, April 5, 2018
HIPAA and Mental Health, Crisis in the Community Conference - Mental Health Association for Greater Baton Rouge, March 10, 2018
Medical Legal Partnerships: Attorneys and Healthcare Providers Working Together to Help Veterans and Other Patients, Moderator, American Bar Association Center for Professional Development Health Law Section Webinar, February 12, 2018
Legal Issues Facing Ambulatory Surgery Centers, Louisiana Ambulatory Surgery Center Association, Annual Conference, February 9, 2018
Lessons Learned from Recent Fraud Enforcement Cases and Settlements, Region 9 Conference, Healthcare Financial Management Association, November 7, 2017
MACRA and Other Important Considerations in Physician Employment Agreements, Presented to Members of the Chicago Medical Society, September 15, 2017
Legal Update: 2017 Hot Topics for Physician Practices, MGMA - Acadiana, September 14, 2017
Legal Update: 2017 Hot Topics for Physician Practices, MGMA - Acadiana, September 12, 2017
Compliance and Enforcement Roundtable Discussion, MGMA Louisiana & MGMA Mississippi Southern Summer Conference, August 17, 2017
What are Medical-Legal Partnerships and How Can I Get Involved?, American Bar Association Center for Professional Development Health Law Section Webinar, July 11, 2017
Legal Update: LASCA Business Meeting, 2017 Gulf States ASC Conference, June 22, 2017
Stark Law and Anti-Kickback Statute Compliance for HFMA Members, Presented to Members of HFMA, June 13, 2017
Emerging Compliance Issues with the Stark Law and Anti-Kickback Statute, Louisiana State Bar Association Healthcare Law CLE, New Orleans, LA, May 25, 2017
Health Care Fraud Enforcement Update: False Claims Act and Beyond, Louisiana State Bar Association Healthcare Law CLE, New Orleans, LA, May 25, 2017
Financial Relationships/Law & Regulations for FQHCs, LPCA Corporate Compliance Institute Services, Session 7, May 3, 2017
Hospital-Physician Contracting: Compliance Issues and Strategies, HCCA Regional Meeting, New Orleans, LA, April 21, 2017
Lasseiz les Bons Temps Rouler: Hope for Potential Stark Law Changes, 18th Annual Conference on Emerging Issues in Healthcare Law, New Orleans, March 10, 2017
HIPAA Compliance And Radiology Practices, Delta States Chapter of RMBA Annual Conference, February 16, 2017
Legal Update: Hot Topics for ASCs in 2017, Louisiana Ambulatory Surgery Center Association 2017 Annual Meeting, January 20, 2017
HIPAA Compliance for Posting Videos to the Web, 2016 American Society for Dermatologic Surgery Annual Meeting, New Orleans, November 13, 2016
Advanced Compliance Seminar, Louisiana Hospital Association Conference Center, September 2015
Fraud and Abuse Traps in Physician Relationships: Lessons Learned from Recent Government Investigations, 2015 MGMA-LA Annual Conference, New Orleans, LA, August 2015
Louisiana ASC Licensing Statutes and Regulations Resource Guide, 8th Annual Gulf States ASC Conference, LASCA Business Meeting, Biloxi, MS, June 18, 2015
Community Clinics, Pharmacies, and Other Opportunities for Physicians and Attorneys to Work Together, ABA Physicians Legal Issues Conference, ABA Health Law Section, Chicago, IL, June 11, 2015
HIPAA Compliance: Recent Changes to the HIPAA Rules and Enforcement Actions, Acadiana Vascular Center, Lafayette, LA, May 15, 2015
Compliance Risk Areas: Where to Begin, Louisiana Hospital Association Basic Compliance Seminar, Baton Rouge, LA, April 29, 2015
Government Investigations, Settlements, and Resulting Compliance Obligations of Long Term Care Providers, Co-Presenter, American Health Lawyers Association Long Term Care and the Law Conference, New Orleans, La., February 24, 2015
Compliance Strategies for Physician Relationships, Health Ethics Trust Conference Southeast Regional, January 28, 2015
The Evolution of a Hospital Compliance Program and the Role of the Compliance Officer, Louisiana Hospital Association 25th Annual Health Law Symposium, November 5, 2014
Hot Fraud and Abuse Compliance Topics for Physician Practices, MGMA New Orleans 2014 Fall Workshop, September 24, 2014
Mental Health Law Update, Louisiana Hospital Association, Baton Rouge, LA, August 20, 2014
An Ethical Dilemma: Hospitalists and the Continuity of Care, ABA Physicians Legal Issues Conference, ABA Health Law Section, Chicago, IL, June 13, 2014
HIPAA Compliance: Recent changes to the HIPAA Rules and Enforcement Actions, R.W. Johnson & Company/Eye Center Surgery Center; Baton Rouge, LA, May 17, 2014
HIPAA Compliance: Recent changes to the HIPAA Rules and Enforcement Actions, Northeast La PHO; Alexandria, LA, May 13, 2014
Why Does Security Get the Back Burner and How to Change That in Your Organization, Roundtable Discussion, HealthTech Research Advisory Council Meeting, New Orleans, Louisiana, April 2014
HIPAA Compliance: Recent changes to the HIPAA Rules and Enforcement Actions, East Jefferson Charity Hospital Family Practice Graduate Medical Education Residents; New Orleans, LA, March 17, 2014
15th Annual Conference on Emerging Issues in Health Care Law, Litchfield, AZ, February 26, 2014
HIPAA Compliance: Recent changes to the HIPAA Rules and Enforcement Actions, Ochsner Graduate Medical Education Residents; New Orleans, LA, January 27, 2014
Legal Updates on Issues Impacting ASCs, Louisiana Ambulatory Surgery Center Association, 2014 Annual Conference, January 23, 2014
Implementing the Omnibus Changes Part II, Including Business Associates and More, 2013 Louisiana HIPAA and E H R Conference; Baton Rouge, LA, October 28-29, 2013
Resolving Legal and Audit Issues in an Internal Compliance Investigation, American Health Lawyers Association, and Health Care Compliance Association, Fraud & Compliance Forum; Baltimore, MD, September 29, 2013
HIPAA Compliance and Enforcement by the Office of Civil Rights: Lessons Learned for Physician Practices, Greater New Orleans Medical Group Management Association; New Orleans, LA, September 26, 2013
HIPAA Compliance Made Easy for Physician Practices, Louisiana Medical Group Management Association 2013 Annual Conference; New Orleans, LA, August 21, 2013
Compliance Topics for ASCs, 2013 Gulf States ASC Conference; New Orleans, LA, June 19, 2013
Current Fraud and Abuse Initiatives Impacting Physicians, 2013 Physician Legal Issues Conference, American Bar Association Health Law Section; Chicago, IL, June 13-15, 2013
Mental Health Law Update, Louisiana Hospital Association; Baton Rouge, LA, May 9, 2013
Implementation - Business Associates and Breach Notification, HIPAA Changes - Understanding and Implementing the Latest Rule, 2013 Louisiana HIPAA & EHR Conference; Baton Rouge, LA, March 11, 2013
HIPAA Compliance: Recent Enforcement Actions and Recent Changes to the HIPAA Rules, Louisiana Orthopedic Association Annual Meeting; New Orleans, LA, March 2, 2013
HIPAA Enforcement by the Office for Civil Rights: Lessons Learned for ASCs, Louisiana Ambulatory Surgery Association Conference, January 24, 2013
Hospital-Physician Alignment Strategies, Louisiana Hospital Association Conference; Baton Rouge, LA, January 24, 2013
Advanced Business Associate Issues, Louisiana HIPAA & EHR Conference; Baton Rouge, LA, September 29, 2012
New Healthcare Delivery Models: Challenges for Physician Practices, Greater New Orleans Medical Group Management Association Compliance Boot Camp; New Orleans, LA, September 26, 2012
Hot Compliance Topics for Physician Practices: 2011 Year in Review, Louisiana Medical Group Management Association 2012 Annual Conference; Lake Charles, LA, April 21, 2012
Fraud and Abuse Compliance in Mental Health Settings, Louisiana Hospital Association/Mental Health Law Update, March 1, 2012
Federal and State Legal Issues Impacting Ambulatory Surgery Centers, Louisiana Ambulatory Surgery Association 2012 Annual Meeting, January 25, 2012
Hospital-Physician Alignment Strategies, Louisiana Hospital Association 22nd Annual Fall Health Law Symposium; Baton Rouge, LA, November 2, 2011
Challenges for Physician Practices Since Healthcare Reform in 2010 and Alignment Strategies for Physicians and Hospitals After Healthcare Reform, Greater New Orleans Medical Group Management Association, September 15, 2011
Managed Care Contracting, Baton Rouge Medical Group Management Association, August 11, 2011
2010 Fraud and Abuse Enforcement Year in Review, Louisiana Society of Hospital Attorneys 21st Annual Health Law Symposium, November 4, 2010
Navigating Fraud and Abuse Issues with Health Care Reform and Other ASC Business Relationships!, 2010 Gulf States ASC Conference; Biloxi, Mississippi, June 15, 2010

Areas of Practice (3)

  • Healthcare
  • Disaster Relief
  • Long-term Care and Senior Living

Education & Credentials

Contact Information:
225.381.8037  Phone
225.381.8029  Fax
www.bswllp.com/clay-j-countryman
Mailing Address:
PO Box 3197, Baton Rouge, LA 70802
University Attended:
University of Oklahoma, B.B.A.
Law School Attended:
Loyola University New Orleans School of Law, J.D.
Year of First Admission:
1994
Admission:
1994, Louisiana
Memberships:

Professional Associations

American Bar Association. Health Law Section

- Secretary of Health Law Section Council, 2018 - 2019, ABA Health Law Section

- HLS Council Member at Large, 2015-2018, ABA Health Law Section

- Medical-Legal Partnerships Work Group, Chair, 2015-2019, ABA Health Law Section

- Vice Chair Health Care Reform Task Force, 2017-2019, ABA Health Law Section

- Physician Legal Issues Conference, Co-Chair 2014, 2015 and 2017, ABA Health Law Section

- ACO Task Force, Vice Chair, 2015-2016, ABA Health Law Section, ABA Health Law Section

- Business & Transactions Interest Group, Chair, 2014-2015, ABA Health Law Section

- eHealth, Privacy & Security Interest Group, Vice Chair, 2011-2012, ABA Health Law Section

- Emerging Issues Conference, Planning Committee, 2005-2006, ABA Health Law Section

American Bar Association, Veterans Legal Services Commission

- Veterans Legal Services Commission Member, 2017-2018, ABA Veterans Legal Services Commission

American Bar Association, Young Lawyer Division

- YLD Liaison to Health Law Section Council, 2002-2004, ABA Young Lawyers Division

- Chair and Vice Chair, YLD Health Law Committee, 2000-2002, ABA Young Lawyers Division

American Health Lawyers Association

Louisiana Medical Group Management Association

Louisiana Hospital Association, Society of Hospital Attorneys, Member

Health Care Compliance Association

Louisiana Ambulatory Surgery Center Association

Healthcare Information and Management Systems Society (HIMSS)

Reported Cases:
Representative Matters: Represented physician groups in the acquisition of the group and subsequent employment by a hospital or health system.; Represented healthcare providers in internal compliance investigations and resolving overpayment and related issues under the Federal False Claims Act.; Advised several health care provider clients on compliance with the Stark Law, Federal Anti-Kickback Statute and other similar laws applicable to their business operations.; Advised physician groups and other health care providers in the formation of joint ventures to own and operate diagnostic imaging centers, hospitals, ambulatory surgical centers and cancer treatment centers.; Drafted and reviewed several types of agreements for healthcare providers, including professional service agreements, employment agreements, physician recruitment agreements, medical director agreements, third-party billing agreements, management agreements, and HIPAA policies and procedures.; Advised health care providers regarding managed care contracting and network provider agreements with commercial insurance carriers and other third-party payers.; Advised physician groups, hospitals and other health care providers to create and implement forms, policies and procedures to comply with the HIPAA Privacy and Security Rules.; Formed limited liability companies and other corporate entities on behalf of health care providers, including drafting and reviewing operating agreements and corporate by-laws.; Advised several types of health care providers to develop and implement a compliance program.; Advised several hospital-based physician groups, including anesthesiologists, radiologists and pathologists, regarding exclusive agreements with Hospitals.
ISLN:
909727459

Peer Reviews

4.7/5.0 (21 reviews)
High ethical standing icon
A Martindale-Hubbell Peer Rating reflects a combination of achieving a Very High General Ethical Standards rating and a Legal Ability numerical rating.
  • Legal Knowledge

    4.8/5.0
  • Analytical Capability

    4.8/5.0
  • Judgment

    4.7/5.0
  • Communication

    4.7/5.0
  • Legal Experience

    4.8/5.0
  • 5.0/5.0 Rated by a Associate on 04/07/16 in Health Care Corporate Law

    Clay is a strong and committed attorney and give a great deal back to the profession

    Clay is a strong and committed attorney and give a great deal back to the profession Read less

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  • 5.0/5.0 Rated by a Associate/Assistant General Counsel on 04/15/16 in Health Care

    Clay Countryman is exceptionally knowledgeable in his practice area. He is responsive and profession and has a great ability to connect with his client, without compromising his position with respect to matter at issue. He has handled complex healt... Read more

    Read more

    Clay Countryman is exceptionally knowledgeable in his practice area. He is responsive and profession and has a great ability to connect with his client, without compromising his position with respect to matter at issue. He has handled complex health and corporate law matters and demonstrated great skill in legal analysis and ability to communicate an opinion. Read less

    Read less

*Peer Reviews provided before April 15, 2008 are not displayed.

Documents (35)

Documents by this lawyer on Martindale.com

Baton Rouge, Louisiana

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