Fraud, Abuse and Regulatory Compliance

Counsel for New Hampshire health care Providers

As government efforts to control fraud and abuse have intensified, the need for providers to have meaningful, comprehensive compliance programs has become ever more important. Shaheen & Gordon, P.A. has been assisting both small and large health care providers to implement effective compliance programs for over 15 years. These are not compliance programs that are drafted and placed on a shelf but rather programs that become a fundamental part of the organizational culture. Each is 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 systems capabilities. Our experience spans a broad array of health care providers including hospitals, physicians, clinics, ambulatory surgery centers, community mental health centers and physical therapy providers. We provider written documentation, implementation, training and on-going follow up.

S&G empower providers with knowledge and experience in each of the following areas as they apply to health care providers:

  • Physician Self-referral laws (Stark)
  • Antikickback
  • False Claims Act
  • Medicare and Medicaid requirements
  • Billing and Coding requirements
  • Health Information Portability and Accountability Act
  • 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 subjected to 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 resolving the issue expeditiously in a manner that is fair and protects the financial viability and the reputation of the provider.

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