Not too long ago healthcare legal matters were focused mainly on regulatory compliance.
Those days are long gone. Today healthcare attorneys handle legal matters from the boardroom all the way to the courtroom. Healthcare operations face legal exposure like never before.
Here’s the deal:
Every healthcare organization needs legal protection more than ever these days. Compliance laws are constantly changing. One little mistake can sink your organization.
What you’ll learn:
- Why Healthcare Legal Practice Areas Have Expanded
- Top 5 Healthcare Law Practice Areas
- How seemingly small Compliance Issues Become Legal Matters
- How to Choose the Right Healthcare Lawyers
Why Healthcare Legal Practice Areas Have Expanded
Let’s look at how dramatically healthcare litigation has increased just this year alone.
The number of healthcare filings in federal court went up 98% in 2024. The growth tells the story of why healthcare law services have become table stakes for healthcare businesses.
There are a variety of reasons we have seen such a boom in healthcare law matters.
New regulations are constantly being introduced. Data breaches are reaching an all-time high. Government enforcement agencies are cracking down harder than ever.
Let’s put it into perspective…
Five years ago most healthcare providers were mainly concerned with Medicare billing compliance. Now they have to worry about HIPAA fines, Anti-Kickback investigations, False Claims Act litigation, and so much more.
That is why hiring specialized Healthcare Lawyers has never been more important. Your healthcare organization needs experts on your side who know how to successfully protect your business against this aggressive landscape.
Top 5 Healthcare Law Practice Areas
Between new regulations, government investigations, business disputes, and clinical liabilities professionals needs to know every angle of healthcare law.
Here are the top 5 healthcare law practice areas:
Compliance Programs
For many years our founding attorneys built their careers defending providers against false claims of non-compliance. So we understand healthcare compliance laws inside and out.
Whether you need a hand with HIPAA, Stark Law, Anti-Kickback, or False Claims Act. We can help you sort it out.
Investigations and Fraud Defense
The DOJ recovered nearly $3 billion in False Claims Act cases in fiscal year 2024. With over $1 billion of that coming from the healthcare industry.
Yep, you read that right. You’re operating in an extremely unforgiving business environment. Medical providers need legal counsel they can trust to defend against fraud allegations and government investigations.
Licensing and Credentialing
It takes physicians years of education and training to get their medical licenses. However they can lose them in a New York minute if they are not careful.
Healthcare providers should never face professional license issues alone. There are many legal specialties that concentrate on health care licensing law. Just make sure you hire one that knows healthcare.
Transactions
Mergers, acquisitions, partnerships. The list goes on when it comes to healthcare business transactions. Every deal has unique requirements. There are laws specific to healthcare transactions your business needs to follow.
Don’t turn to your general practice lawyer when dealing with complex healthcare transactions. You need healthcare transaction experts who know the ins and outs of healthcare law.
The Litigation Game
When your business gets hit with a lawsuit you need fierce attorneys on your side who know healthcare.
Whether you are facing a clinical malpractice lawsuit or government enforcement action you want experienced healthcare lawyers fighting for you. You also want them to be well versed in negotiation strategy. Not all legal battles need to go to court.
How seemingly small Compliance Issues Become Legal Matters
Here’s what most healthcare providers don’t understand…
It doesn’t take much for a small compliance mistake to turn into a huge legal battle. A simple coding error can land you in a DOJ investigation. Forgetting to enforce a policy could result in a lawsuit against your organization.
The typical route from compliance issue to full-on legal matter looks something like this:
Violation > Detection > Enforcement > Lawsuit
Here is a better way to think about it…
You make a mistake or fail to follow a regulation. Then somebody finds out about it. Whether it is an auditor, another physician, or a patient. Then the government decides to crack down on you or that person decides to sue you. Before you know it you are bogged down in a legal battle.
The good news is that most legal battles can be avoided.
If you have a robust compliance program in place you can catch these errors before they happen. Auditing your practices regularly will allow you to find and fix problems. Working with strong healthcare attorneys can help you stay in compliance.
But let’s be real…
When you do find yourself in a legal battle you need strong healthcare attorneys on your side who know how to handle these situations. You need healthcare lawyers that understand healthcare and how to litigate healthcare specific cases.
Navigating Healthcare Regulations
Healthcare regulations seem to be a moving target these days. What may have been compliant last year may not be this year.
The key things healthcare providers should be keeping their eyes on are:
Federal healthcare regulations
Just because you may be compliant with state laws does not mean the feds will agree. Stay on top of federal regulations as they often set the tone for state regulations.
Changes in enforcement priorities
Every new presidential administration brings a shift in regulatory enforcement. Knowing these agency enforcement intentions can help you understand how hard they will crack down on violations.
Industry best practices
Sometimes regulations don’t explain every little detail. That is where industry best practices can help guide you when writing your own policies.
State specific regulations
Each state has different regulations your business needs to follow. You should always research your state’s compliance laws.
This is a lot to keep up with. You shouldn’t have to figure it out alone.
How to Choose the Right Healthcare Lawyers
Not all lawyers are cut out for healthcare.
Just because your attorney knows how to draft a contract does not mean they know healthcare. Ask yourself these questions when evaluating if your lawyer knows healthcare:
- Do they know healthcare specific regulations like HIPAA?
- Do they know Medicare and Medicaid reimbursement rules?
- Do they know the Anti-Kickback Statute and False Claims Act?
- Can they explain medical acronyms to you in plain English?
If you answered no to any of the above questions it may be time to consult with a healthcare attorney.
Also, keep in mind that general practice lawyers are more inclined to handle your legal matters within their comfort zone. Meaning they may not want to tackle complex healthcare regulations.
You want a healthcare law firm that:
- Specializes in healthcare law.
- Has experience defending similar cases to ones you could possibly face.
- Has the resources to handle big time litigation if necessary.
Cost shouldn’t be your main factor when selecting a healthcare law firm. Yes, legal help can get expensive. But you want the best protection money can buy when it comes to legal matters. And trust us when we say you will need legal protection.
Think about it…
As soon as you are served with a lawsuit or investigative letter the clock starts ticking. You want to have already established relationships with qualified healthcare attorneys so you can respond immediately and correctly.
Wrapping It Up
Healthcare legal matters have grown to require far more than just general compliance guidance.
Healthcare organizations are attacked from all angles these days. You have government enforcement agencies at your doorstep. Fraud allegations. Business disputes. Medical malpractice lawsuits. You name it.
There are so many ways your organization can be attacked legally.
Healthcare organizations need to have a solid compliance program in place. They also need to work with healthcare attorneys they can trust. Staying informed on new regulations is critical. You should always be preparing for the next attack your business could face.
And when that attack happens you want your legal team ready and waiting to respond.
Don’t wait until you are served that lawsuit or investigative letter to find your healthcare lawyer.
