Our practice concentrates on the business and regulatory issues of health care. We help clients of all sizes working in almost all aspects of the health care industry. We have longstanding relationships with our clients and with the regulatory agencies that impact their work. Our recent and current matters involve the following broad areas:
Health Care Transactions
The firm has assisted with or handled the purchase, sale, and merger of various client types. We have formed entities and structured relationships for countless transactions as the health industry has evolved. Ms. Brewer has led negotiations and crafted documentation for the sale of practices, service entities, information systems, independent physician associations, management service organizations, transportation, and intellectual property.
Recently, the firm negotiated and documented the sale and transition of a California managed care payer to a Fortune 100 buyer. The firm also negotiated and documented the sale and transfer of Certificate of Need (CON) rights of several skilled nursing facilities to a publicly-traded buyer. The firm also worked with a client team to identify a private equity buyer and negotiate the sale of a client's laboratory developed test and its data platform. The firm has structured transactions for the operations of specialty pharmacies, research laboratories, specialty providers, data companies, clinical research organizations and telehealth providers.
Health Care Compliance, Fraud & Abuse
The firm regularly advises clients on matters that implicate fraud and abuse laws. Ms. Brewer regularly answers client questions related to anti-kickback, anti-referral, antitrust laws and the corporate practice of medicine doctrine. The firm has guided clients with voluntary disclosures and repayment plans with the Office of Inspector General (OIG). The firm has experience with the analysis of acceptable relationships for marketing, sales, management services, billing, recruitment, shared risk, and HIPAA compliance.
Medicare & Medicaid Participation and Reimbursement
We help clients become eligible, revalidated, credentialed and contracted to provide care. Our firm has helped small and large providers navigate this process to avoid deactivation and to remain eligible to provide care and be paid for it. We have unique skills to help clients confidently submit Disclosure Statements and provider application materials to enroll or maintain enrollment with payers. Our firm helps providers of all types determine what information needs to be updated and when an update is required. We understand and navigate the PECOS and PAVE systems, as well as the programs linked to Medicare and Medi-Cal enrollment.
Managed Care Participation and Reimbursement
As more individuals are covered by managed care arrangements, remaining eligible as a provider is essential. We work with all plans and IPAs to secure participation and to challenge a plan’s decision to deny a provider participation. Scores and data submission can often mean the difference between profitability and growth versus stagnation and decline. We understand this and offer some solutions.
False Claims Act / Whistleblower Cases
The firm has successfully resolved California and federal false claims allegations for clients. The firm successfully resolved allegations for several clients in California's largest false claims case. The firm worked with nationally-recognized white-collar criminal defense counsel to resolve whistleblower allegations involving clinical trials and laboratory developed tests. The firm regularly consults with relators' counsel and industry consultants concerning regulatory requirements surrounding false claims allegations. Ms. Brewer has negotiated and assisted with the implementation of Corporate Integrity Agreements involving state attorneys general, the Department of Justice, and the Office of Inspector General. The firm has experience demonstrating evidence of “inability to pay,” which can be required to resolve false claim allegations.
Telehealth and Mobile Health Care
For more than a decade, the firm has worked with providers on the forefront of digital and mobile health care. The firm evaluates technology and devices for clients, and works with innovators developing both. We have represented ancillary providers who deliver mobile services for dentistry, behavioral health, radiology, and laboratory services. The firm has launched telehealth programs for primary, specialty and rural areas. We have helped providers receive reimbursement and document services provided through telehealth.