Payor Disputes, Investigations, Quality of Care and Patient Privacy Issues
Weinberg Wheeler Hudgins Gunn & Dial’s Healthcare Practice Group helps healthcare clients navigate the complicated laws that govern the provision and administration of healthcare services across the country.
We provide experienced counsel and guidance to our healthcare clients on a variety of legal matters, including but not limited to:
- Representing hospitals and healthcare providers nationwide with peer review, medical staff and credentialing matters in compliance with state and federal laws, such as the Healthcare Quality Improvement Act of 1969 (as amended) and reporting to the National Practitioner Data Bank.
- Representing physicians, dentists and other healthcare providers before various state licensing boards.
- Advising healthcare systems, facilities and physician practices in response to third party requests for patient information, subpoenas and issues involving HIPAA and other state and federal privacy laws regarding healthcare records and information.
- Representing healthcare providers in connection with inspections and investigations by state and federal government, including ADA complaints.
- Counseling facilities in regard to patient consent issues.
- Providing prompt response to unique and general healthcare legal issues as they arise.
- Litigating payment disputes between providers and payors for both in-network and out-of-network services.
- Investigating healthcare fraud and pursuing claims related to fraudulent billing and various kickback schemes.
- Litigating whether benefits have been properly paid (or denied) under various relevant state and federal laws, including state prompt-payment laws, ERISA, and the Medicare Act.
- Representing Managed Care Organizations including Health Maintenance Organizations in connection with civil litigation related to negligence, contracting, provider credentialing and facility credentialing.
- Successful representation, including two lengthy trials, of major Managed Care Organization in civil litigation involving numerous claimants bringing individual suits resulting in favorable resolution of cases.
- Providing advice and counsel to healthcare providers and physician groups on contracting and non-compete agreements.
- Litigating class action claims related to Medicare reimbursements.
- June 9, 2017