Understanding

Healthcare Transactions:

Laws and Regulations

A healthcare transaction refers to any financial or business interaction involving a healthcare provider, such as a hospital, clinic, or individual practitioner, and a payer, such as a private insurer or a government-funded program like Medicare or Medicaid.

These transactions can include billing for services rendered, negotiating reimbursement rates, and purchasing or selling medical equipment or facilities.

Healthcare transactions also include the buying and selling of healthcare companies, mergers and acquisitions of healthcare providers, as well as private equity investments in healthcare companies. These transactions are subject to various laws and regulations, such as the Anti-Kickback Statute and the Stark Law, to prevent fraud and abuse in the healthcare system.

The Anti-Kickback Statute (AKS) is a federal law that prohibits the exchange (or offer to exchange), of anything of value, in an effort to induce (or reward) the referral of federal health care program business. The AKS is a criminal statute that applies to anyone who knowingly and willingly participates in such conduct. Penalties for violation of the AKS include fines, imprisonment, and exclusion from federal health care programs. The law is intended to ensure that medical decisions are made based on the best interests of the patient, rather than financial gain.

The Stark Law, also known as the Physician Self-Referral Law, is a federal law that prohibits physicians from making referrals for certain designated health services to entities in which they (or their immediate family members) have a financial interest, unless an exception applies. The law applies to physicians who participate in Medicare and Medicaid programs. The purpose of the Stark Law is to ensure that financial considerations do not interfere with medical decision making and to prevent overutilization of health care services. Violations of the Stark Law can result in fines, exclusion from federal health care programs, and damage to a physician’s reputation.

Having an attorney review a healthcare transaction is important because these transactions can be complex and subject to various laws and regulations. An attorney can help ensure that the transaction is compliant with these laws and regulations, and can help protect the parties involved from potential legal consequences.

An attorney can review the terms of the transaction, including any agreements or contracts, to ensure they are fair and reasonable. They can also review the financial aspects of the transaction, such as reimbursement rates and billing practices, to ensure compliance with laws and regulations.

Additionally, an attorney can help navigate the regulatory approval process for certain types of transactions, such as mergers and acquisitions, to ensure that the transaction is approved in a timely manner. They can also assist in the due diligence process to identify and mitigate any potential legal or regulatory issues that may arise.

In summary, an attorney’s review and guidance can help protect the parties involved in a healthcare transaction from potential legal risks, and ensure that the transaction is compliant with relevant laws and regulations.

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About

Haque Law

Our firm represents a vast portfolio of clients in the business and healthcare industry. With over 40 years of combined experience, not only do we have in-depth legal knowledge, but we have direct hands-on experience inside the business and healthcare industry as owners and operators of pharmacies, executives of clinics, and managers of micro-hospitals. Our team is dedicated to building long-term personable relationships through long-lasting solutions. We achieve this by taking the time to better understand our clients goals and needs. Our ability to relate to our clients’ needs sets us apart from other law firms.

Unique Qualifications

It’s rare to find a group of attorneys that have both operational and legal experience in the healthcare industry. More importantly, it’s even harder to find a law firm that’s built on long term relationships. It’s our experience and relationships that help us tackle any and all issues that our clients may face making us the best in the business.

Stress Free

It is easy to solve problems. It’s much harder to keep problems away. Our approach to issues and resolutions is what stands us apart from other law firms. Our ability to relate and think outside of the box allows us to put policies, procedures, resolutions and agreements in place to keep our clients compliant.

Your Success Is Ours

We define success by our clients success. Oftentimes, the needs of our clients is to simply establish relationships with others in the industry. Watching our clients’ success grow by the relationships we establish is the core to our success ratio. 

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