Healthcare Compliance, Regulatory Matters, HIPAA, Peer Review, & Managed Care

In a heavily regulated healthcare industry, the attorneys at London Amburn bring experience and understanding of the complex and constantly changing statutory and regulatory framework in which healthcare providers do business. Our attorneys work with various healthcare providers to review and structure business arrangements, taking into consideration the Stark self-referral law, the Anti-Kickback Statute and the False Claims Act, as well as Tennessee healthcare laws. We also regularly advise physicians, physician groups, allied health professionals, diagnostic facilities, and other ancillary healthcare providers about issues arising under the federal and state reimbursement laws and regulations and work with clients to develop strategies to deal with voluntary reporting and repayments to third party payors.

Our clients seek guidance in developing and implementing compliance programs to monitor ongoing regulatory compliance in their business operations and to ensure the protection of private health information. London Amburn attorneys work with healthcare clients – and those who do business with them – to develop the policies and procedures required to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its evolving privacy and security standards.

London Amburn also offers legal advice about group peer review cases. Our attorneys have experience with situations where physicians are subject to group peer review and have assisted the physicians with their provider dispute resolution process, including appeals of unfavorable decisions regarding network participation privileges. The attorneys at London Amburn advise clients on the importance of protection of the confidentiality of peer review activities throughout the process.

While the concept of managed care was intended to reduce the cost of providing health benefits and improve the quality of care, healthcare clients may nevertheless face denial of reimbursement in a variety of situations. The attorneys of London Amburn have achieved favorable results for clients in dealing with managed care organizations in resolving contested matters.

Our Experienced Healthcare Compliance Attorneys

Patti T. Cotten (Co-Chair)

Patti T. Cotten (Co-Chair)

Diana L. Gustin (Co-Chair)

Diana L. Gustin (Co-Chair)

Karin Anderson

Karin Anderson

Ian P. Hennessey

Ian P. Hennessey

Charles S. J. Sharrett

Charles S. J. Sharrett

Daniel T. Swanson

Daniel T. Swanson

Jennifer Pearson Taylor

Jennifer Pearson Taylor

Erin B. Williams

Erin B. Williams

Legal Services

 

Healthcare Law

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Corporate & Business Law

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Healthcare Compliance, Regulatory Matters, HIPAA, Peer Review, and Managed Care 

Products Liability Defense

Business Litigation

Civil Trial Practice

Nursing Home & Long Term Care Defense

Federal Civil Rights & Corrections Healthcare Defense

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Government & Private Payor Reimbursement Claims Defense

Healthcare Board Investigations

Medical Staff Issues

Transportation

Workers’ Compensation Defense

Appellate Practice

Mediation Services

Healthcare Compliance, Regulatory Matters, HIPAA, Peer Review, & Managed Care

In a heavily regulated healthcare industry, the attorneys at London Amburn bring experience and understanding of the complex and constantly changing statutory and regulatory framework in which healthcare providers do business. Our attorneys work with various healthcare providers to review and structure business arrangements, taking into consideration the Stark self-referral law, the Anti-Kickback Statute and the False Claims Act, as well as Tennessee healthcare laws. We also regularly advise physicians, physician groups, allied health professionals, diagnostic facilities, and other ancillary healthcare providers about issues arising under the federal and state reimbursement laws and regulations and work with clients to develop strategies to deal with voluntary reporting and repayments to third party payers.

Our clients seek guidance in developing and implementing compliance programs to monitor ongoing regulatory compliance in their business operations and to ensure the protection of private health information. London Amburn attorneys work with healthcare clients – and those who do business with them – to develop the policies and procedures required to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its evolving privacy and security standards.

London Amburn also offers legal advice about group peer review cases. Our attorneys have experience with situations where physicians are subject to group peer review and have assisted the physicians with their provider dispute resolution process, including appeal of unfavorable decisions regarding network participation privileges. The attorneys at London Amburn advise clients on the importance of protection of the confidentiality of peer review activities throughout the process.

While the concept of Managed Care was intended to reduce the cost of providing health benefits and improve the quality of care, healthcare clients may nevertheless face denial of reimbursement in a variety of situations. The attorneys of London Amburn have achieved favorable results for clients in dealing with managed care organizations in resolving contested matters.

Our Experienced Healthcare Compliance Attorneys

Patti T. Cotten (Co-Chair)

Patti T. Cotten (Co-Chair)

Diana L. Gustin (Co-Chair)

Diana L. Gustin (Co-Chair)

Karin Anderson

Karin Anderson

Ian P. Hennessey

Ian P. Hennessey

Charles S. J. Sharrett

Charles S. J. Sharrett

Daniel T. Swanson

Daniel T. Swanson

Jennifer Pearson Taylor

Jennifer Pearson Taylor

Erin B. Williams

Erin B. Williams