Healthcare Attorneys & Medical Law Practitioners
Representing Healthcare Professionals in Long Island, New York
Our firm represents physicians and other healthcare providers such as, but not limited to, psychologists, physical therapists, occupational therapists, and dentists and we serve as their counsel. At Birzon & Associates in Smithtown, we take great care to provide exceptional representation for a wide range of healthcare matters. Our knowledgeable lawyers have decades of experience assisting our healthcare clients in Nassau and Suffolk counties and are committed to helping you achieve your objectives.
What is Healthcare Law?
Healthcare law is a branch of law that covers the regulation and provision of health care. It can be divided into three main areas: public health law, health care administration, and health insurance. Healthcare law encompasses a wide range of legal issues, including patient rights, medical malpractice, long-term care planning, and access to healthcare.
Public health law is concerned with preventing disease and promoting health. It includes laws that govern the operation of public health agencies and regulations that protect the public from exposure to health hazards. The public health law also covers tobacco control, immunization, and food safety issues.
Health care administration laws govern the operation of health care facilities and health insurance plans. These laws establish the quality of care, patient safety, and provider credentialing standards. They also regulate the financing of health care, including Medicare and Medicaid.
Health insurance law regulates the private health insurance industry. It covers benefit design, coverage requirements, and insurer solvency issues. Health insurance law also governs the operation of health exchanges, which are marketplaces for buying and selling health insurance plans.
The Affordable Care Act (ACA) is the most significant piece of healthcare legislation. The ACA was passed in 2010 and has been the subject of intense political debate since its enactment. The ACA made substantial changes to the health care system, including expanding health insurance coverage to millions of Americans. The ACA also established health exchanges, which are online marketplaces for buying and selling health insurance plans. The ACA is currently the law of the land, but its future is uncertain given the change in administration.
Areas of Health Law
The legal structures that have emerged from health law are complex and diverse. Many of the problems in health law are complicated and varied. Health attorneys may focus on one issue for a large firm, or they can assist a healthcare company with a range of legal needs, including:
Manufacture of Medical Equipment and Pharmaceutical Products
The health care industry also includes the manufacture of medical equipment and pharmaceuticals. These products are subject to strict regulation by the U.S. Food and Drug Administration (FDA). The FDA regulates the safety and efficacy of all drugs sold in the United States. Pharmaceutical companies must submit extensive data on new drugs before they can be approved for sale.
The FDA also regulates medical devices. All medical devices must be cleared or approved by the FDA before being marketed. The FDA regulates medical devices to ensure that they are safe and effective.
In addition to the FDA, health care facilities and providers are also regulated by state and federal laws. These laws govern everything from the licensing of healthcare providers to the standards of care that healthcare facilities must meet.
Establishment and Management of Health Care Organization
Organizations that offer health services rely on attorneys to assist them in incorporating and running their operations. Provider organizations require assistance to incorporate as a company, maintain records and submit reports. They may need assistance with day-to-day activities such as contracting with service providers after they’re up and running.
Health care lawyers also can help healthcare organizations with strategic planning. This may involve long-range planning for growth or downsizing, merger or acquisition activity, development of new products and services, and compliance with state and federal health regulations. Many law firms representing healthcare organizations have healthcare compliance lawyers on staff to address these issues.
Lawyers also are needed to help resolve disputes that health care organizations have with patients, other providers, health plans, or government agencies. This may involve drafting legislation affecting health care, such as laws governing the practice of telemedicine across state lines.
Fraud and Abuse
The healthcare law includes many provisions designed to crack down on fraud and abuse in the healthcare system. These provisions make it easier for prosecutors to go after health care fraudsters, and they give new tools to Medicare and Medicaid to help prevent fraud before it happens. There are several different types of health care fraud, including insurance fraud, drug abuse, and professional misconduct.
The health care law also strengthens whistleblower protections so that people who report fraud can do so without fear of retaliation. Finally, the healthcare law provides new resources to help train healthcare providers on how to avoid fraud and abuse.
There are many different aspects of health care law, but one of the most important is compliance. Compliance refers to making sure that health care providers and facilities follow all applicable laws and regulations. This includes everything from ensuring that patients receive the proper care and treatment to ensuring that medical records are properly maintained.
For instance, The Office for Civil Rights (OCR) enforces HIPAA and sets standards for protecting patient health information. The Centers for Medicare and Medicaid Services (CMS) oversees the quality of care given to Medicare and Medicaid patients. State health departments also have compliance programs in place.
Insurance and the Third-party Payer System
In the United States, health insurance is mainly provided through a third-party payer system. This means that an insurer or health plan—not the patient—pays for health care services. The patient usually pays a premium to the health plan, and the health plan, in turn, contracts with providers (such as doctors, hospitals, and pharmacies) to provide health care services to enrollees (those who have signed up for the health plan). The health plan then reimburses the health care provider.
Health attorneys specialize in advising their clients on how to comply with health insurance regulations and conflicts. When parties disagree over whether a health insurance deal should cover a medical expense, they turn to healthcare attorneys to fight it out. Health insurers also require legal counsel to guide them through understanding, executing, and complying with federal and state laws regarding health insurance.
Health care law is a relatively new and evolving area of law. It is constantly changing as health care reform efforts are enacted at the state and federal levels. As health care becomes more expensive and complex, health care lawyers will play an increasingly important role in ensuring that health plans comply with the law and that patients receive the coverage they need.
Contact Us For a Free Initial Medical Legal Consultation
We represent healthcare providers, such as hospitals and physicians. We also may represent health plans, patients, or other individuals with healthcare-related issues. If you have a question about your rights or obligations under healthcare laws, contact us.
Accomplished Healthcare Attorneys And Litigators Represent The Medical Profession
On Long Island, our firm has a strong reputation for representing the healthcare industry and the depth of our experience will benefit you as a healthcare professional. Call us at 631-265-6300 if you have issues relating to the following matters.