Few industries or professions are subject to the complex federal and state system of laws, regulations and compliance obligations as those operating in the healthcare industry. Physicians, chiropractors, dentists, Board Certified Behavior Analysts (BCBA), nurses, physical therapists, pharmacists, ambulatory surgery centers, laboratories, medical billing companies, and medical payors are each subject to distinct licensing and regulatory systems, and governed by separate governing bodies. The complexities of applicable laws impacting healthcare professionals is best illustrated by the existence of conflicting laws between even neighboring states such as New York and New Jersey, where a multi-disciplinary practice or a professional partnership between a medical doctor and chiropractor are permitted under the laws in the state of New Jersey but unlawful in the state of New York.
In addition to distinct state licensing and regulatory requirements and obligations, companies and businesses in the healthcare industry are subject to and impacted by a significant number of other highly complex areas of law, such as the Health Insurance Portability & Accountability Act of 1996 (HIPAA) and its complex system of regulations; the Employee Retirement Income Security Act of 1974 (ERISA); the False Claims Act; the Anti-Kickback Statute; Physician Self-Referral Law; and the Clinical Laboratory Improvement Amendments (CLIA).
For the past 16 years and counting, Sarmasti PLLC has served clients in the healthcare industry and can provide services in any of the following areas:
- Physician and chiropractic organizations, multidisciplinary practices, and individual healthcare providers
- Dental partnerships and practices
- Behavioral Health Practices and Board Certified Behavior Analysts (BCBA)
- Nurses, physical therapists, respiratory therapists, and other licensed healthcare professionals
- Pharmacists and pharmacies
- Ambulatory surgery centers
- Ambulatory care facilities
- Medical billing companies
- Urgent care facilities
- ERISA litigation
- Clinical Laboratory Improvement Amendments (CLIA) regulations
- Shareholder, member, partner disputes, litigation or arbitration
- Contractual or transactional matters, including litigation and dispute resolution
- Complex insurance litigation or arbitration
- Hospital medical staff privileges dispute
- Litigation under state and federal anti-kickback and fraud abuse statutes
- Professional licensing board matters and administrative proceedings
- Medical staff hearings
- New Jersey Codey Law and Insurance Fraud Prevention Act
- PIP arbitrations
- Healthcare employment contract and litigation matters
- Formation of healthcare practice, preparation of bylaws and operating agreements,
- Healthcare practice acquisitions or mergers
- Insurance fraud defense
- Insurance non-payment or underpayment litigation and resolution
- Insurance and Medicare or Medicaid audit or investigation defense
- Appeals
- HIPAA and privacy/confidentiality matters
- Preparation or review of internal compliance policies and procedures
- Fraud and abuse investigations, allegations, and indictments
- New Jersey Department of Banking and Insurance (DOBI) investigations
- New Jersey Department of Banking and Insurance (DOBI) subpoenas
