Legal compliance in business planning for healthcare providers:
Why do legal compliance and business planning overlap? The healthcare lawyers at Jackson LLP help ensure that your business idea is feasible and congruent with the professional, legal, and regulatory limitations on your practice. This means ensuring that your business plan isn’t premised on a profit scheme that violates the Stark Law, Anti-Kickback Statute, False Claims Act, or state self-referral and kickback laws. It also must avoid violations of individual providers’ practice acts, which may prohibit fee-splitting.
Not all professionals are permitted to undertake joint ventures, so a careful analysis must be performed to ensure that the proposed business will not violate self-referral and anti-kickback laws, qualifies for registration with the IDFPR, and complies with each provider’s statutory and ethical requirements.
Ensure that the type of work you intend to perform is something for which you can purchase insurance. Our attorneys can work closely with you through the establishment of an LLC or corporation, and we provide liability guidance to ensure that you take full advantage of your corporate protections and are insured for the work that you are performing.
Any comprehensive liability plan also involves reliance upon professionals whose expertise can help limit the likelihood of mistakes, legal violations, and liability claims against you and your new business. Your team should include:
- Healthcare attorney well-versed in health laws
- Accounting professional who works with healthcare practices
- Medical biller if you will be accepting third-party reimbursement
- Insurance broker to help with your professional, CGL, auto (if a concierge practice), and renter’s insurance needs
When opening a business, the first consideration is often the uncertainty of a new practice’s financial stability. Jackson LLP’s attorneys work closely with clients to realistically address questions like:
- Who will refer patients to my practice? Will those referrals violate any laws?
- When can I expect my business to turn profitable?
- Will I accept insurance, government payor plans, or only cash?
- What upfront legal, accounting, and real estate costs will I have?
It is also important to remember that healthcare laws and restrictions apply whether you see 50 patients each week or 1 patient each year. You have the same obligation to comply with anti-kickback, self-referral, patient privacy, and other requirements – and violations of these requirements may subject you to hefty fines or jail time. If you cannot or will not comply with these laws, then owning a practice may not be for you. They are not optional, and with the federal government continuously ramping up audits of healthcare professionals, the risk is substantial. Whether you’re treating one patient “on the side” in their home after your day job, or you’re seeing a few of the women from your weekend play group for cash, you remain obligated to comply with the laws imposed upon members of your licensed profession. You place your practice, financial security, and professional license at risk if you don’t follow them.
Hit the ground running:
To ensure your success, our attorneys often suggest that you perform tasks like:
- Claim your Google, Yelp, and other online listings. Keep information accurate and up-to-date.
- Establish a relationship with a medical biller to handle your third-party payor claims, allowing you to focus on growing your practice and patient care.
- Verify that your current employment contract doesn’t prohibit you from executing your plan. We recommend having a healthcare attorney review it for things like a non-solicitation, non-competition, or anti-moonlightling clause, among others.
- Launch a website – even a single-page website functions as a modern-day business card, and it lends legitimacy to your practice.
- Speak with others who own their own practices to get a realistic idea about when you can expect to start turning a profit.
- Evaluate the cost of services like your EMR/EHR software, HIPAA-compliant email program, HIPAA-compliant phone system (not Google Voice!), and practice security systems (when deemed necessary based upon your HIPAA risk assessment).
Our attorneys offer a free initial consultation, at which time we will discuss your specific goals and how we might help you accomplish them. Schedule your call below.