Health care laws and regulations are perpetually in a state of flux and the rate of change is only speeding up as evidenced by the past several years. The seemingly unending challenges and changes resulting from health care reform, the ACA, HIPAA, HITECH Florida's pain clinic statute and changes to its professional licensure statutes, and other similar laws, including medical records privacy, Medicare provider enrollment and fraud and abuse, ACO regulations, and enforcement and compliance...Read more
Health care laws and regulations are perpetually in a state of flux and the rate of change is only speeding up as evidenced by the past several years. The seemingly unending challenges and changes resulting from health care reform, the ACA, HIPAA, HITECH Florida's pain clinic statute and changes to its professional licensure statutes, and other similar laws, including medical records privacy, Medicare provider enrollment and fraud and abuse, ACO regulations, and enforcement and compliance reforms, professional licensure challenges, shrinking reimbursements and privacy/security concerns, can be overwhelming for otherwise busy and highly-performing medical practices, physicians, health care organizations, licensed facilities and other health care providers and professionals.
These non-medical but obligatory regulatory requirements and business processes take time, energy and resources away from what matters most — caring for your patients. That said, failing to rise to the challenge may cause legal, professional or financial stress and even catastrophe; many of the aforementioned areas are interrelated, and a problem or simple oversight in one area can cause a ripple effect, at times endangering a physician's career or an entire medical practice or organization.
These challenges are forcing health care providers to merge, grow bigger, and consolidate and integrate with one another in order to survive and prosper in a marketplace that is driven by a high demand for quality health care services and lack of funding to pay for that demand with state and federal governments looking to impose more and more regulation on providers at every turn. For instance, the ACA encourages the integration of hospitals, doctors and other types of health care providers at while trying to take aim at the underlying problem: the U.S. has evolved the developed world's most inefficient health-care delivery system and one that too often rewards volume of care and not quality of care. That evolution has caused doctors and health care professionals to have to practice defensive medicine and leaves them without meaning tort reform and clear guidance on billing and claims submission for Medicare and other third-party payors. That conundrum in turn creates risk, if not a nightmare, according to regulators and health insurers. The proliferation of hospital mergers and hospitals' appetite for acquiring and buying doctors' practices, in part to ensure a steady stream of patients to fill hospital beds could create anti-trust and monopoly concerns that raise prices without increasing efficiency. That in turn will cause payors to look to challenge claims and also to possibly engage in economic credentialing or providers. In that end, it will lead to scrutiny by federal and state government regulators and consumer and patient dissatisfaction that could result in medical malpractice lawsuits, professional licensure investigations, Medicare audits and challenges to claims, peer review actions, managed care contracting and payment disputes, medical record privacy concerns, and other regulatory and legal challenges on an increasing level which the health care system and its participating professionals and providers have not yet experienced and for which they may be unprepared.
If you or your organization is faced with health care law challenges, our attorneys at the Longwood, Florida, law firm of Michael R. Lowe, P.A., are ready to bring our years of experience and expertise to help you address any issue efficiently and effectively, preserving your financial and legal interests.
Our lawyers work exclusively on health care law matters and issues. We are ready to bring the expertise that has helped hundreds of clients achieve ideal resolutions to work on your matter or case.
To schedule an initial consultation to discuss health and health care law/litigation with one of our Florida health and health care law/litigation attorneys, call 407-332-6353 or contact Michael R. Lowe, P.A. online.Read less