Healthcare, Long-Term Care & Assisted Living
The Doyle & Nelson team represents hospitals, federally qualified health centers, assisted living facilities, nursing homes, mental health providers and other health care entities and practitioners at every intersection of health care and the law.
Our practice includes facility development and finance; corporate and transactional services; staff privilege and health care employment matters; clinical practice issues; and privacy and regulatory compliance with the requirements of laws such as HIPAA, Section 501(r) of the Internal Revenue Code, and the fraud & abuse, physician self-referral, and anti-kickback laws and regulations.
MaineCare and Medicare Recoupment Actions
As the government grapples with rising health care costs, health care providers find themselves under increasing scrutiny, recoupment audits in particular.
In addition to inflicting financial devastation, civil judgments for recoupment can lead to severe collateral consequences, such as license revocations, exclusion from government health care programs, and criminal prosecution for health care fraud. When threatened with these recoupment investigations, health care providers should enlist qualified, experienced attorneys as early in the process as possible — MaineCare and Medicare recoupment audits included.
Doyle & Nelson has a proven track record of successfully guiding health care providers through every stage of the MaineCare/Medicare recoupment process, responding to audits, as well as challenging findings in administrative and judicial proceedings. Whether through negotiation or litigation, we have saved our clients hundreds of thousands of dollars in penalties.
Regulatory compliance for health care providers is a complex web of federal and state law. Doyle & Nelson provides practical solutions to these challenges, helping our clients reach their compliance goals in areas such as Medicare, EMTALA and HIPAA through the design, implementation and review of compliance plans, including the use of internal monitoring and investigations.
Licensure, Certification and Accreditation
Doyle & Nelson represents health care providers in all aspects of licensure, certification and accreditation, including state licensing, Medicare/Medicaid certification, Joint Commission, and NCQA accreditation matters.