Representing Doctors And Medical Professionals In Houston, Texas
Our health care attorneys have a history of assisting various types of health care professionals for various types of needs. Our attorneys can assist in setting up new practices, negotiating office leases and drafting employment contracts. We can assist with helping a practice comply with fraud and abuse laws like the Stark Law, the Anti-Kickback Statute and the Federal False Claims Act. Our attorneys can also defend medical providers in disputes with Medicare, Medicaid or private insurance regarding billing and reimbursement practices.
Health care law attorney, Jonathan Wu, has experience addressing Medicaid and Medicare overpayment matters and health care fraud claims. Mr. Wu is knowledgeable in Stark Law and the Anti-Kickback Statute. He can assist on matters relating to nursing home state and regulatory issues. Mr. Wu can provide a strategic, aggressive defense necessary to protect you and your business. Richard Weaver has represented physicians in various matters including those related to physician practices, employment and business development. He has experience with laboratory business matters as well. He has been involved in disputes related to the operation of Level 4 laboratories, medical and vaccine research, and the safeguarding of sensitive research materials. He has represented clients in matters pertaining to the United States Government’s investigation related to the international transportation of sensitive materials for medical research. Richard Weaver’s experience includes medical malpractice defense, business disputes, medical equipment lease issues and commercial lease matters for medical offices. Mr. Weaver has also worked on numerous lawsuits related to pharmaceutical products liability.
We are a Texas law firm based in Houston, Texas, but also covering San Antonio and other cities and towns throughout the State of Texas. To learn more about our services and how we can help you and your business, please call 713-454-7875.
Attorneys For Houston, Texas Health Care Providers
Many health care providers including hospitals, medical equipment suppliers, physicians and home health agencies receive incorrect payments from Medicare or Medicaid. The Weaver Law Firm can assist and defend health care providers in Texas that need assistance in overpayment claims. The Weaver Law Firm can assist in appeals related to alleged Medicare overpayments.
The Weaver Law Firm and its Health Law lawyers can represent medical professionals and health care providers in health care fraud matters. If you suspect that you may be the subject of an investigation, please contact an experienced attorney. If the Office of Inspector General (OIG) or the Attorney General’s Office reaches out to you for what seems to be a preliminary interview, call an experienced attorney. They may be looking for information that can trigger a formal investigation or statements that could be used against you later.
Attorney Representation In The Medicare Overpayment Appeal Process
There are several different levels of appeal. At the first stage, the Medicare contractor is asked to review the overpayment. The contractor will then provide a decision that either changes the previous determination or denies the claim. If the claim is denied, then the second stage is initiated. At the second stage, a qualified independent contractor reviews the overpayment. A Health Law attorney can assist in offering supporting documentation to contest the overpayment. At the third stage, a provider that requests the previous outcome can have a hearing. An administrative law judge would oversee the hearing. The Office of Medicare Hearings and Appeals oversees this process. The detail of this process is important because it may require the presentation of evidence and witness testimony. The fourth stage of appeals would require a written appeal. This is a detailed process that an attorney at The Weaver Law Firm can help you address. The fifth stage of appeal would be a federal court lawsuit.
Health care providers can find themselves in audits and addressing claims relating to:
- Anti-kickback violations
- Federal False Claims Act violations
- Self-referral law – Stark Law
- Stark Law exceptions
- Audits from the Texas Department of Insurance
- TRICARE Fraud Investigations
- Health and human services investigations
- Office of Inspector General (OIG) investigations
- Medicare and Medicaid fraud
- Recovery Audit Contractor program – RAC audits
- Issued dealing with the establishment of doctor-patient relationships
Our attorneys provide thoughtful representation in overpayment matters. We can assist you with investigations from regulators and law enforcement. Typical investigations may be conducted by the Medicaid Fraud Control Unit or Health Integrity.
Medical Practice Advice On Regulations And Transactions
There are several regulatory requirements that health care professionals must implement. Our health and medical law attorneys can assist by helping put together:
- Written policies and procedures for compliance training and corrective action plans
- Guidelines for training and education programs
- Procedures outlining auditing and monitoring
We can also provide legal assistance on health care-related transactions, including:
- Formation of business entity
- Equipment purchase agreements
- Equipment lease agreements
- Commercial lease agreements
- Joint venture agreements
- Investments agreements and business purchase agreements
- Partnership agreements and partnership disputes
- Confidentiality and non-disclosure agreements
- Independent Contractor agreements
- Physician employment agreements
- Non-compete agreements
Results come first in health law and health care-related transactions. We have the experience to achieve them in even the most challenging matters. Our clients appreciate the fact that we are loyal to their businesses and communication well.
Frequently Asked Questions About Health Care Law
Health care law is a complex web of legal realities facing health care providers, from private practices to nursing homes. Health care laws govern the issues of payment and fraud, but there are many complexities to the law that you have to contend with, and you have a lot of questions. We can help answer those questions, but to get started, here are answers to a few of the most often-asked questions we get:
What are the risks in medical billing?
Inaccurate – or fraudulent – billing can run the risk of creating red flags in the system. If Medicare or insurance companies notice red flags, they’re likely to closely review all activity. This investigation can often lead to Medicare or insurance fraud allegations.
What happens if you’re accused of Medicare or Medicaid fraud?
Accusations of Medicare fraud, Medicaid fraud or insurance fraud are extremely serious. These are criminal actions, and you face stiff penalties. However, you will have the opportunity to defend yourself against allegations. We can help you build your defense in these instances.
What are the guidelines I must follow to maintain my license?
Texas, like every state, has its own guidelines for doctors, nurses and other health care professionals to retain licenses. These often include continuing education and adherence to ethical guidelines.
If you face allegations of violating any ethical or legal standard, that can place your license and livelihood in jeopardy and that will create difficulties for you.
Are there exceptions to the Stark Law?
Yes, there are. The Stark Law regulates referrals by doctors who bill government programs such as Medicare or Medicaid. It means a doctor can’t refer anyone to a practice that they have a financial relationship with.
This can preclude a hospital from hiring a doctor who also bills Medicare or Medicaid. But there are exceptions that can allow a company to circumvent. It’s best to discuss these options with a skilled attorney.
Experience | Loyalty | Communication | Results
From Houston to San Antonio our Texas law firm aims to deliver reliable legal solutions. You can call The Weaver Law Firm at 713-454-7875.