Last Updated on: 13th October 2023, 05:17 pm

Representing New York Physicians and Medical Practices

Lawyers who focus their practice on healthcare law have a unique opportunity to help New York physicians and medical practices navigate the complex legal and regulatory environment they face. From ensuring compliance with state and federal regulations to providing counsel on day-to-day issues, healthcare attorneys serve a vital role for doctors and their practices. This article provides an overview of some of the key areas where New York healthcare lawyers assist physicians and medical groups.

Licensing and Regulatory Compliance

One of the most important services healthcare attorneys provide is guidance on licensing and ongoing regulatory compliance. Physicians in New York must be licensed by the state to practice medicine. The initial licensing process involves meeting educational and training requirements, passing exams, and completing background checks and other application requirements. Once licensed, physicians must comply with a web of regulations at both the state and federal level. Healthcare lawyers help doctors understand and meet these obligations.Some of the key regulatory schemes include:

• New York Public Health Law – Governs the practice of medicine and other health professions in the state. Sets licensing requirements, defines professional misconduct, and establishes oversight by the State Board for Professional Medical Conduct.
• HIPAA – The federal Health Insurance Portability and Accountability Act includes strict privacy and security rules physicians must follow when handling protected health information.
• Medicare and Medicaid Rules – Doctors who accept Medicare and Medicaid patients must comply with complex billing, coding, documentation and other program requirements. An experienced healthcare lawyer can provide invaluable assistance navigating these rules.
• FDA Regulation – Physicians often use medical devices, biologics, pharmaceuticals and other products regulated by the Food and Drug Administration. Navigating FDA rules and staying up to date on new approvals, warnings and recalls can be challenging without legal guidance.
• Controlled Substances Act – Physicians who prescribe controlled substances like opioids must register with the DEA and follow strict rules on prescription practices. Healthcare counsel can help ensure compliance.

In addition to federal mandates, New York physicians may face local regulations such as public health reporting duties. Healthcare attorneys keep up with regulatory changes so doctors can focus on providing care.

Practice Organization and Operation

In addition to regulatory compliance, healthcare lawyers can provide invaluable counsel on the business side of operating a medical practice. Key areas where legal guidance is helpful include:

• Forming a business entity – Many physicians choose to organize their practices as professional corporations (PC), limited liability companies (LLC) or partnerships. Healthcare lawyers can advise on the pros and cons of each structure and prepare the necessary organizational documents.
• Employment matters – Larger practices employ nurses, technicians, administrative staff and other personnel. Counsel can assist with drafting employee policies, employment contracts, and navigating laws like wage and hour rules.
• Contract review – Medical practices enter into many contracts – leases, managed care agreements, service provider deals, etc. Experienced healthcare lawyers help negotiate favorable terms and spot potential pitfalls.
• Insurance – Doctors need various types of insurance, including medical malpractice coverage. Healthcare attorneys assist in procuring adequate policies at reasonable rates.
• Billing and reimbursement – Navigating insurance claims, coding and collecting payments is extremely challenging. Healthcare counsel can help streamline billing processes and maximize appropriate reimbursement.
• Medical records – Special rules govern maintaining, accessing, disclosing and destroying patient medical records. Healthcare lawyers ensure practices follow proper procedures.
• Technology issues – From electronic health records systems to data security, technology poses many legal issues. Healthcare counsel can address questions in this complex area.

Healthcare Transactions

Physicians looking to expand their practices often turn to experienced healthcare lawyers for advice on mergers, acquisitions, joint ventures and other transactions. Counsel plays a crucial role negotiating deals, conducting due diligence, and documenting agreements to further the client’s strategic goals while limiting risk. Common transactional issues attorneys can assist with include:

• Practice sales – Attorneys represent both buyers and sellers in medical practice sale transactions. Key considerations include valuation, financing, transfer of assets and liabilities, allocation of purchase price, employment and compensation matters, and regulatory compliance.
• Mergers – Healthcare counsel handles the legal intricacies involved when medical practices merge, including corporate structuring, governance, financial and tax implications.
• Equity investments – Attorneys advise practices seeking private equity investments on deal terms, capital structure, investor rights, and securities compliance issues.
• Joint ventures – Forming joint ventures with hospitals, health systems and other providers to share resources and risk requires experienced legal guidance.
• Contracting with payers – Negotiating participation agreements with health plans, accountable care organizations and other payers is complex. Healthcare lawyers level the playing field.

Using counsel for transactions helps physicians avoid potential pitfalls and maximize the value of deals.

Healthcare Litigation

Despite best efforts, physicians sometimes end up in disputes that may lead to litigation. Common situations where healthcare attorneys can help include:

• Medical malpractice – Defending malpractice lawsuits is a key service healthcare litigators provide. This can involve extensive pretrial preparation, retaining experts, settlement negotiations and trial.
• Billing disputes – Counsel can aid doctors fighting adverse coverage or reimbursement decisions, including insurance claim denials and audits.
• Stark/Anti-Kickback – Healthcare lawyers are familiar with these complex federal fraud and abuse laws and can defend government investigations or lawsuits.
• Licensing/disciplinary – Attorneys represent physicians in license application and disciplinary disputes before state medical boards.
• Peer review proceedings – Hospitals and medical staffs sometimes take adverse peer review actions against doctors, which counsel can appeal or litigate if warranted.
• Non-compete/trade secret litigation – Healthcare attorneys can go to court to protect physicians’ competitive interests in disputes with former partners or employers.

With an experienced litigator, physicians have an advocate to represent their interests in legal disputes.

Additional Services

Beyond the broad categories above, healthcare lawyers can advise doctors on many other issues including:

• Tax planning and compliance
• Estate planning and wealth transfer
• Medical spa regulations
• Website legal compliance
• Nonprofit formation and governance
• Advocacy before state and federal agencies
• And many more!

In summary, New York healthcare attorneys serve physicians and medical groups in a multitude of ways – from ensuring compliance with a complex regulatory framework, to providing counsel on business operations and transactions, to advocating for doctors in litigation. With healthcare law expertise, attorneys become trusted advisors who allow physicians to focus on providing top-notch patient care. Doctors facing legal questions would be wise to consult experienced healthcare counsel.