Kean Miller provides health care regulatory and compliance services, tax and legislative counsel, and litigation advice through a multidisciplinary team of attorneys.
Our team represents physicians, physician groups, physical therapists and rehabilitation agencies, continuing care retirement communities, pharmacy providers, durable medical equipment (DME) suppliers, billing companies, skilled nursing facilities, personal care attendant (PCA) and waiver providers, nurses and nurse practitioners, and social workers. Our attorneys have experience defending qui tam (whistleblower) lawsuits; disciplinary actions brought by licensing boards, facilities and third party payers; MAC/RAC/PSC and ZPIC audits; Medicaid audits; and private insurance audits. Kean Miller also develops corporate compliance plans, provides regulatory and compliance advice, and advice and opinions on compliance with both the Stark law and state and federal anti-kickback statutes and regulations. We regularly negotiate arrangements between and among health care providers, as well as ancillary service providers, such as billing companies. Other experience includes assisting criminal defense attorneys in health care fraud cases.
Kean Miller attorneys have represented the following before their relative licensing boards: physicians, physician assistants, nurse practitioners, nurse midwives, registered nurses, dentists, pharmacies, pharmacists, wholesale drug distributors, physical therapists, social workers, psychologists, radiologic technologists, emergency medical technicians, and optometrists.
Representative Experience
- Successfully resolved a multi-state, multi-millon dollar qui tam federal court mater, without any resulting exclusions or integrity agreements
- Regulatory counsel for the second largest multi-specialty physician group practice in Louisiana. The practice currently has 100 physicians
- Represented physicians in more than 65 cases before the Louisiana State Board of Medical Examiners (LSBME), the physician licensing board
- Represented physicians in licensing board matters in Texas, New York and Alabama
- Represented partial hospitalization program (CMHC) in defense of a Medicare post-payment Program Safeguard Contractor (now ZPIC) audit - obtained reduction in overpayment from $760,000 to less than $10,000, through Administrative Law Judge (ALJ) hearing
- Represented physician group practice in defense of a Medicare post-payment Program Safeguard Contractor (now ZPIC) audit - obtained reduction in overpayment from $650,000 to under $100,000 through second level of appeal
- Developed and produced HIPAA compliance materials for more than 200 members of the Louisiana Independent Pharmacies Association
- Participated on behalf of a provider in the Self-Referral (Stark Law) Disclosure Protocol promulgated under the Patient Protection and Affordable Care Act (PPACA)
- Handled the merger of physician group practices
- Obtained first federal appellate court decision in the United States holding there is no private right of action under the Health Insurance Portability and Accountability Act of 1996 (HIPAA)
- Negotiated numerous physician recruitment agreements, employment agreements, and medical director agreements
- Assisted criminal defense attorneys in federal controlled substance cases, health care fraud cases, and private insurance fraud investigation under federal criminal law
- Successfully defended single state agency audits and state Attorney General investigations under the Louisiana Medical Assistance Program Integrity Law (MAPIL)
- Successfully defended Home and Community Based Waiver (HCBW) providers in adverse licensure actions
- Successfully defended numerous providers in Medicare/Medicaid audits
- Represented nurse practitioners and registered nurses in more than 20 cases before the Louisiana State Board Nursing (LSBN)
- Represented national preferred provider organization (PPO) in class action litigation
- Represented physicians with hospital credentialing and privileges disputes
- Provided advice and opinion letters to providers on Stark law and regulations, and federal and state anti-kickback statutes and regulations
- Negotiated professional services agreements between radiation oncologists, emergency room physicians, radiologist, anesthesiologists and/or pathologists with the following facilities:
- Our Lady of the Lake Regional Medical Center
- Lake Imaging Center
- St. Elizabeth Hospital
- Baton Rouge General Medical Center
- Woman's Hospital
- Louisiana Spine and Sports Medicine
- Outpatient Surgery Center for Site
- St. James Parish Hospital
- Advanced Surgical Care of Baton Rouge
- Greater Baton Rouge Surgical Hospital
- Lane Regional Medical Center
- Perkins Plaza Ambulatory Surgery Center
- The Neuromedical Center Hospital
- BRASS
- West Louisiana Parish Hospital
- Surgery Center of Hammond
- Surgical Specialty Center of Baton Rouge
- Orthopedic Surgery Center
- Gonzales Endoscopy Center
- Pennington Cancer Center
Our Health Law Team includes attorneys listed in Best Lawyers in America and in Louisiana Super Lawyers. The attorneys are also involved in community service and pro bono activities. They regularly provide educational programs on health law-related topics for clients and friends.
At Kean Miller, health care providers' issues, questions and challenges are perceived as an opportunity for clients to move their businesses forward in new and creative ways in the complex field of regulatory compliance.
