Healthcare

Regulatory Compliance and Operational Guidance

Our attorneys counsel clients on compliance with federal and state laws such as the Anti-Kickback Statute, Stark Law, False Claims Act, HIPAA, and beneficiary inducement rules. We assist with structuring transactions—including mergers, acquisitions, joint ventures, and affiliations—to meet business objectives while adhering to regulatory requirements. From medical staff bylaws and credentialing to quality management and governance, we help healthcare organizations maintain operational integrity and mitigate risk.

Licensing, Accreditation, and Credentialing

We guide providers through licensure and accreditation processes, ensuring compliance with state boards, CMS enrollment, and pharmacy benefit manager (PBM) contracting. Our team also advises on enrollment in Medicare, Medicaid, and managed care programs, as well as negotiating payor agreements to optimize reimbursement.

Audits, Investigations, and Enforcement Defense

Healthcare providers face frequent audits and investigations from CMS contractors, commercial payors, and state agencies. Our attorneys have extensive experience in responding to payor audits, subpoenas, and civil investigative demands. We represent clients in administrative appeals and defend against allegations of fraud, waste, and abuse. When enforcement actions escalate, we provide vigorous representation in civil and criminal matters before the Department of Justice, HHS-OIG, DEA, FDA, and state authorities.

Reimbursement and Revenue Cycle Support

Our team advises on Medicare Parts A–D, Medicaid coverage, reimbursement issues, and assists with audit preparation and appeals. We help clients identify documentation gaps, improve claim submission processes, and resolve disputes with payors to protect revenue streams.

Strategic Transactions and Business Counseling

Healthcare is a business as well as a calling. We support clients in negotiating contracts, managing risk, and executing strategic transactions. Whether advising on corporate governance, joint ventures, or private equity investments, our attorneys deliver solutions that align with both regulatory demands and business goals.

Let’s Talk

With decades of combined experience and a national client base, our Healthcare Group offers comprehensive legal services tailored to the unique challenges of the industry. We don’t just interpret regulations—we anticipate changes and craft proactive strategies that keep our clients ahead. By leveraging our firm’s strengths in corporate law, litigation, and employment, we provide integrated counsel that addresses every facet of a healthcare organization’s legal needs.

To learn how Brown & Fortunato’s Healthcare Group can assist with regulatory compliance, reimbursement issues, audits, or strategic transactions, contact us to connect with one of our healthcare attorneys.