Fraud, Abuse and Regulatory Compliance

Counsel for New Hampshire Health Care Providers

As government efforts to control fraud and abuse continue to intensify, the need for providers to have meaningful, comprehensive compliance programs has never been more important. Shaheen & Gordon has been assisting health care providers of all sizes in the implementation of effective compliance programs for over 20 years.

An effective compliance program is one that becomes a fundamental part of the organizational culture. S&G creates programs that are tailored to meet the individual needs of the provider based on the type of services offered, the size of the organization, the available resources, and the system capabilities. Our experience spans a broad array of health care providers, including hospitals, individual and group practices, clinics, ambulatory surgery centers, community mental health centers and physical therapy providers. We provide written documentation, implementation, training and on-going follow up.

S&G empowers providers with knowledge in the full range of health care regulatory requirements that are crucial to health care providers success such as:

  • Physician self-referral laws (Stark)
  • Anti-Kickback Statute
  • False Claims Act
  • Medicare and Medicaid requirements
  • Billing and coding requirements
  • Health Information Portability and Accountability Act (HIPAA)
  • Emergency Medical Treatment and Active Labor Act (EMTALA)
  • American with Disabilities Act
  • Clinical Laboratory Improvement Act
  • Electronic health records
  • State licensing requirements

In those cases where providers find themselves the targets of governmental scrutiny, whether, by the Office of the Inspector General, the U.S. Department of Justice, the State Medicaid Fraud Unit or otherwise, S&G stands ready to provide a vigorous defense. We work to resolve issues expeditiously in a manner that is fair and protects the financial viability and reputation of the provider.

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