Health care providers are challenged by the complex and evolving laws and regulations, often invasive government investigations, and complicated industry-specific operational standards to uphold, while simultaneously running a profitable, compassionate, and compliant medical practice.
The Health Care Practice Group at Pashman Stein Walder Hayden understands the ever-changing legal environment in the health care field and provides a wide range of legal services for our diverse health care clients. Our team is proactive and tireless in protecting the rights and livelihood of our clients. We do not wait for solutions to come to us; we actively seek them out, advocating for our clients at every turn.
Our health care clients include physicians, dentists, nurses, and other health care professionals, practice groups, medical societies, and facilities such as surgical centers, urgent care centers, nursing homes and other long-term care facilities, physicians’ offices, chiropractors, independent diagnostic testing facilities (IDTFs), imaging providers, laboratories, pharmacies, addiction treatment centers, and home health care agencies.
Civil and Criminal Defense
Pashman Stein Walder Hayden offers health care clients access to skilled and respected litigators who have extensive experience in civil and criminal defense. Our attorneys have represented health care professionals and entities against governmental and private adversaries and have appeared before administrative hearing boards and investigative agencies, as well as federal and state courts.
Our attorneys have handled complex cases involving a wide range of health care allegations, including:
- Violations of the Anti-Kickback statute and self-referral regulations
- Improper billing and coding
- Improper use of unlicensed individuals and institutional licensing and credentialing issues
- Improper prescribing and distribution of controlled dangerous substances
- Antitrust compliance
- Fraud and abuse investigations by federal agencies, including the Office of the Inspector General of Health and Human Services (OIG), Department of Justice (DOJ), Drug Enforcement Administrations (DEA), and Federal Bureau of Investigations (FBI)
- Fraud and abuse investigations by state agencies, such as departments of health (DOH), Department of Banking and Insurance (DOBI), and State Attorneys General (AG).
Regulatory and Compliance Issues
The Health Care Practice Group advises clients on compliance with health care regulations including HIPAA/HITECH, Anti-kickback Statutes, Stark Law, and respective state regulations in New Jersey and New York.
We also represent clients in investigations, audits, and refund demands by private insurance companies, Medicare, and Medicaid.
Licensing Boards and Hospital Credentialing
We represent health care professionals in professional licensure defense before licensing Boards, such as the New Jersey State Board of Medical Examiners (BME), the New Jersey State Board of Dentistry, the New Jersey State Board of Psychological Examiners, the New York Office of Professional Medical Conduct (OPMC), and the New York Office of Professional Discipline (OPD).
We also represent clients in hospital medical staff matters, credentialing issues, and hospital disciplinary actions, including hospital summary suspensions and fair hearings.
We represent clients in the highly regulated industries of medical cannabis and cannabis-derived products, such as cannabidiol (CBD), by assisting health care professionals in navigating the complex developing laws, including those related to the authorization of medical cannabis.
Health Care Transactional Matters
We provide counseling on diverse transactional matters that affect health care professionals and businesses by advising health care providers on how to deal with the constantly evolving medical marketplace. This work includes advising clients on mergers and acquisitions, various business ventures, and creative health care business arrangements.
Health Care Practice Management Counseling
We serve as outside counsel to numerous medical practices and businesses in New Jersey and New York, as well as to many medical societies. Our practice management legal services include assisting clients in the day-to-day operation of their health care business, including employment contracts; health care regulatory compliance; operating, shareholder, and vendor agreements; practice acquisitions and sales; and employee handbooks.
Our firm is proud of the results it has achieved for clients, some of which are noted here. Of course, each legal matter is unique on many levels, and past successes are not a guarantee of results in any other pending or future matters.
- Represented prominent cardiology group and individual cardiologists in a business tort case brought against them by a specialty hospital asserting claims of tortious interference and unfair competition relating to the group’s referral practices. Retained after the trial court had just denied defendants’ motions for summary judgment and facing a trial that was expected to last several months, we spearheaded the filing of new motions for summary judgment that raised dispositive issues that had not yet been addressed in the more than seven-year-old litigation. Following extensive briefing, the trial court dismissed all of the hospital’s claims with prejudice. The hospital had been seeking nearly $30 million in compensatory damages and an award of punitive damages. On appeal, the Appellate Division affirmed the dismissal of 99% of the hospital’s damages claim and remanded for further proceedings on claims valued at less than $300,000. The case settled during trial, shortly after the parties selected a jury and delivered opening statements.
- Represented a physician in a federal prosecution for allegedly receiving kickbacks from a laboratory-services provider.
- Representation of a client in connection with the sale of a former nursing home site in Jersey City.
- Represented an international publicly-held pharmaceutical company in connection with responding to multiple third party subpoenas in a multi-district litigation.
- Representation of medical practices and other health care providers with regard to investigations by the New Jersey State Attorney General’s Office and the New Jersey Office of the State Comptroller, Medicaid Fraud Division, as well as the New York State Attorney General’s Office.
- Representation of doctors accused of improper billing practices and health care fraud in federal court.
- Representation of an individual in a tele-health company accused of health care fraud and a kickback scheme in federal court.
- Representation of a doctor in a federal health care fraud case related to kickbacks from blood lab.
- Obtained a favorable result for two prominent doctors from New Jersey who were indicted by the Attorney General’s Office of New Jersey for healthcare fraud, committing bribery, and acting as a runner for medical providers. In the initial round of pre-trial motions, the defense obtained a dismissal of healthcare fraud and acting as a runner charges. Ultimately, the defense persuaded the office of Attorney General to permit the doctor involved to be accepted into the Pre-Trial Intervention Program which resulted in the ultimate dismissal of the commercial bribery charge – without any admission of guilt or culpability by the doctor involved. At all times, each doctor steadfastly maintained his innocence.
- Successfully represented on appeal a prominent doctor who had been convicted of two criminal charges involving unlawful sexual contact with a patient. Although this firm did not serve as trial counsel, it was established before the Appellate Division that the doctor in question did not receive a fair trial and the conviction was reversed
- Represented health care professionals in refund demands by private insurance companies, including successfully obtaining successful resolutions of a multi-million-dollar demand.
- Represented physicians and dentists in mergers and acquisition transactions with other medical/dental groups, private equity entities, or hospital systems.
- Represented physicians in employment negotiations with hospitals and medical practices.
- Represented physicians in dispute with hospital systems.
- Represented physicians investigated by the New Jersey Department of Banking (“DOBI”), and defended civil law suits filed by DOBI.
- Drafted medical staff bylaws.
- Represented physicians in investigations commenced by the New Jersey State Board of Medical Examiners due to allegation of discriminate prescribing, as well as assisted physicians in successfully reinstating their medical licenses.
- Represented physician seeking reinstatement of medical license in the State of New York, including appealing the Board of Regents denial to the New York Appellate Division.
- Represented physicians and medical practices in Office Civil Rights investigations stemming from allegations of HIPAA violation or civil rights violations.
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