HEALTHCARE PROVIDER SERVICES

HEALTHCARE PROVIDER SERVICES

At Aeton Law, we do not represent hospitals or groups owned by hospitals. We represent healthcare providers and their groups only. Our loyalty is undivided.

Our goal is to be your outside general counsel—always there when you need us. We focus on the key pressure points for providers and their practices so you can focus on making patients better. These pressure points include (a) getting paid the right amount–payors and contracting with payors; (b) hospitals—credentialing, peer review and other medical staff issues; (c) government—healthcare regulatory, licensing (DPH) and government payor issues and program participation; (d) internal partnership disputes among providers (including operating agreements and dissolutions); (e) advice about the business of healthcare practice; and (f) employment law issues (everything from non-competes and employment agreements to disabled providers).

Dealing with Payors

Treating patients and getting paid. With ever increasing deductibles and co-insurance, providers spend more and more time and effort just to get paid their negotiated rates. Our attorneys regularly deal with difficult payors and patients and how to approach the gordian knot that insurers have created. The Firm keeps abreast of the latest trends, laws and regulations to help you get paid as quickly as possible. This includes surprise billing laws, ERISA and payors’ transformation from insurers to third-party administrators (TPAs).

We also represent providers and their groups in retrospective audits by payors.

Dealing With Hospitals

The Firm’s attorneys counsel providers about hospital/provider relationships, credentialing and medical staff issues. Whether it is a medical staff dispute, compliance with bylaws, or responding to inquiries, our attorneys are ready to help you. Our attorneys have extensive experience with medical staff fair hearings and federal and state litigation involving staff privileges. We routinely help providers resolve disputes, allowing them to continue to practice without worrying about administrative burdens or interference.

Departing Provider

The Firm represents providers when they depart from their practice and helps them navigate non-compete and non-solicit agreements, notify and retain their patients, negotiate financial terms with a new practice and draft, review and edit new employment agreements.

Employment Law Issues

The Firm’s attorneys are well versed in all aspects of employment law, from leave issues (state and federal FMLA) to discrimination and sexual harassment claims (Title VII and the CFEPA), to disabled and impaired providers (the ADA and CFEPA). We counsel providers and their groups on independent contractor versus employed status as well as all of the nitty gritty regulatory issues that employers must attend to under Connecticut and federal law. But unlike many other employment lawyers, we understand how those issues, laws and regulations apply to providers and their practices.

Business Issues

Aeton represents many healthcare practices and small business. With decades of experience, we have confronted and analyzed many of the business issues providers encounter (from bank financing to cost analysis of adding a new provider or practice area to oversight of contractors when you are expanding your office). Aeton lawyers assist healthcare practices in their everyday contracting, compliance, employee relations, employee benefits, and even immigration issues. Advising clients on the latest developments in health care, employment and business law, our attorneys are at the forefront of helping clients avoid problems that can prevent a client from enjoying the greatest success possible. Our lawyers can be your sounding board and provide you with the information you need to make good business decisions.

Negotiating Contracts

We help providers negotiate contracts with hospitals, hospital systems, vendors and others and review contracts for compliance with law, including Stark and Anti-Kickback. The Firm also prepares and reviews non-compete, non-solicit and employment agreements.

In the face of regulatory hurdles, modern day providers must also deal with insurers and TPAs and the financial impact such organizations can have on their practices. The Firm’s attorneys can assist providers so they can successfully negotiate payor/TPA contracts and equalize the playing field.

Our attorneys have considerable experience negotiating contracts for providers who rarely have the time or the expertise to negotiate with large insurers or TPAs. Appropriate contract language can go a long way in protecting providers against liability and assisting them to ensure proper payment under payor agreements.

Government Regulation

Our attorneys provide advice on Stark and Anti-Kickback laws and help providers and their practices insure that their agreements and business relationships comply with these statutes and their regulations. In addition to federal healthcare fraud and abuse laws, our attorneys counsel providers about various licensure and state regulatory requirements.

Our attorneys are experienced in representing providers in actions by state licensure boards seeking to impose sanctions (e.g., license probation, suspension, revocation, etc.) and other disciplinary action against providers. The Firm represents clients in hearings, administrative proceedings and National Practitioner Data Bank matters.

Buying and Selling your Practice

We help provider groups acquire other practices or groups, sell their practices to hospitals or other providers, and create joint venture arrangements from formation to closing. Our attorneys negotiate purchase agreements to protect the value you and your partners have built.

Litigation

The Firm has deep experience in representing providers in litigation, from class actions against payors, ERISA claims for payment against payors, improper termination claims against payors, collection actions against patients, non-compete and non-solicitation cases on behalf of providers or practices, to disputes among partners leading to breach of fiduciary duty cases, and others. Our goal is always to avoid litigation but having litigation experience informs all of the work we do in helping providers and their practices.

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