Health Care Laws Are Meant To Protect Everyone Involved

Alaska’s health care providers planning to establish new facilities or expand existing services must, under certain circumstances, first obtain a Certificate of Need (CON) from the Department of Health and Social Services. This complicated administrative process is compounded by other laws and regulations governing health care facilities, operations and transactions.

Birch Horton Bittner & Cherot attorneys help clients obtain the appropriate facility licensing for their practices, including applying for a CON when necessary. We also help clients identify the appropriate legal requirements for their scope of services, working with them to develop, maintain and expand their practices in a manner that best suits their financial and structural needs. Additionally, our health care attorneys provide guidance to individual and institutional clients to help protect their provider licenses, including responding to complaints, notices of violations and compliance audits.

Birch Horton Bittner & Cherot attorneys assist clients with all aspects of CON applications, including navigating clients through the approval process and challenging applications from competitive entities when appropriate. In addition, we help clients:

• Meet CON application timetables and requirements
• Explore the possibility of applicable exemptions to the CON requirements
• Work with state agencies to facilitate consideration of CON applications
• Prepare a compelling case and assist in drafting effective applications
• Obtain appropriate licenses
• Identify and work with experts in accounting and medical fields
• Review applications for regulatory compliance

In addition, we have experienced health care attorneys who are able to assist clients in any legal forum, having had extensive experience litigating CON determinations, challenges and appeals at the administrative level and in state court. Whether it is in the initial application process or litigation after issuance, we have the background and experience to serve our clients well.

Birch Horton Bittner & Cherot has attorneys skilled in analyzing and responding to health care audits, regardless of the government entity issuing the audit. Receiving an audit letter or any request for information from the government can be intimidating and confusing. We have the background and experience to assist our clients during this stressful process. Our lawyers work with various agencies to make sure that audits are conducted fairly and promptly while carefully collaborating with our clients to ensure that they are in full compliance.

In the event that an appeal of an agency’s determination is necessary, Birch Horton Bittner & Cherot attorneys have the knowledge and resources to step in and assist our clients in navigating the process. We have a proven track record in handling audits and have successfully appealed certain results.

The health care industry is very unique – what works in other industries may not work for a health care practice. This includes employment relationships, where there is no such thing as a “standard employment agreement.” Birch Horton Bittner & Cherot attorneys have the background and experience needed to address the specialized needs of medical practices and health care providers. The services we provide include negotiating and drafting agreements and advocating for clients in the resolution or litigation of employment disputes that include issues such as restrictive covenants, licensing and privileges, ethical practices, reporting requirements, structured compensation plans and compliance with reimbursement regulations and policies.

We have represented health care industry clients in state and federal courts, administrative proceedings and arbitration in a wide variety of complex civil litigation matters involving employment practices in the health care industry.

Health care is among the fastest-growing industries in the United States, and while advancements in treatments create new opportunities every day, growth does not come without challenges – economic stresses, increased scrutiny and government regulations have increased the risks facing health care providers. Failure to navigate the risks properly can result in disruptive disputes and litigation. Birch Horton Bittner & Cherot attorneys understand the challenges faced by businesses in the regulated health care industry and know how to get clients back to business fast.

Our considerable knowledge of the health care industry is the cornerstone of Birch Horton Bittner & Cherot’s health care industry litigation practice. Our attorneys support their clients in courts, arbitration, mediation and administrative proceedings by combining in-depth experience in health care matters with litigation skills developed in trials and hearings. Our attorneys are also skilled at responding to government investigations and negotiating settlements. We provide comprehensive litigation services for any disputed matter and strive to achieve the results for our clients that make sense in the context of the industry and the client’s role in the health care environment.

Birch Horton Bittner & Cherot health care litigation attorneys serve a wide variety of providers, including doctors, hospitals, surgery centers and others. We defend health care providers in regulatory actions arising out of the various regulatory and statutory restrictions placed on those in the industry.

We also represent physicians, nurses and other health care professionals and hospitals in disputes regarding staff privileges, misconduct, credentialing, employment, contractual arrangements, compensation and problems arising from partnerships and joint ventures. These matters typically involve complex ongoing relationships requiring firm but sophisticated handling of the issue in dispute to seek a creative solution.

Our health care litigation team also handles employment and benefits. Our litigators are experienced in addressing claims of discrimination, the Employee Retirement Income Security Act (ERISA) violations and wrongful termination.

At Birch Horton Bittner & Cherot, our attorneys’ experience in mergers and acquisitions includes representing both sellers and purchasers of privately held businesses. We advise clients on transaction structure and legal terms, assist in negotiating the transaction, prepare the necessary documents to effect the transaction and handle closings. We provide advice on issues involving Alaska securities, employment, real estate, environmental and other laws relevant to a specific transaction.

Birch Horton Bittner & Cherot attorneys also advise clients regarding buyouts, reorganizations and the restructuring of businesses to achieve the clients’ objectives, including management and owner succession plans, liquidity and resolution of conflicts among owner groups. We have significant experience with management buyouts, leveraged buyouts and other specialized acquisition transactions. We are skilled in preparing documents and taking other legal steps necessary to implement these transactions.

Because an acquisition sometimes requires the formation of a new business entity, the Birch Horton Bittner & Cherot team also advises clients in all aspects of organizing a new company. These services include assessing business structures; issuing stock or other equity to founders; drafting buy-sell, voting or other agreements among owners; and implementing employment agreements and employee incentive arrangements. Our experience includes organizing large and small privately held corporations, partnerships, limited liability companies, real estate investment trusts, professional corporations and nonprofit organizations.

Birch Horton Bittner & Cherot attorneys regularly advise clients on issues related to the Health Insurance Portability and Accountability Act (HIPAA). Our HIPAA attorneys assist clients in ensuring their compliance with security and privacy requirements for health care information.

Although HIPAA has become synonymous with patient privacy, Alaska health care providers need to be equally concerned with the Confidentiality of Medical Information Act (CMIA). Together, these two laws address not only patient privacy requirements, but also electronic standardization, security and other requirements governing the handling and transmission of health information.

Federal and Alaska state laws have significant differences in the area of patient privacy. With respect to coverage, for example, HIPAA regulations apply to “covered entities,” which include health care providers who transmit health care information in electronic form (using a standard transaction), health care clearinghouses (e.g. billing companies) and health plans. CMIA, by contrast, has a far broader scope of coverage. In many areas, CMIA is actually more stringent than HIPAA in establishing safeguards for patient privacy.

Birch Horton Bittner & Cherot attorneys routinely design and implement HIPAA compliance plans, which the Health Information Technology for Economic and Clinical Health Act (HITECH Act) rendered mandatory for both covered entities and business associates beginning on February 17, 2010. In addition to preparing compliance plans, we provide the following specific services:

• Audits of the state of HIPAA compliance in your organization
• Provision of business associate agreements and other HIPAA-compliant contracts
• Preparation of HIPAA-compliant security and privacy policies and procedures
• Service on an ongoing basis as HIPAA compliance counsel
• Workforce training

Our HIPAA attorneys counsel providers to determine and ensure compliance with HIPAA and CMIA. We also work with providers who are responding to allegations of noncompliance by state and federal regulators. We have assisted numerous providers in developing compliant notices and practices, including government hospitals, physicians and other medical care providers.

Health Care organizations in the United States face a baffling patchwork of state and federal laws and regulations. Birch Horton Bittner & Cherot attorneys provide experienced counsel on the full range of health care regulatory issues to entities in virtually all health care sectors.

Medical privacy is a major concern in the industry, and violations are now subject to increased enforcement action with risk of greater penalties. We advise clients on issues and regulations under the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act.

Birch Horton Bittner & Cherot also provides sophisticated counsel on reimbursement issues arising under Medicare, Medicaid and other government health programs. Today’s enforcement environment for health care entities often requires a proactive approach to regulatory operations. Our lawyers interface with all relevant federal and state regulatory and enforcement agencies and work with clients and trade associations to guide government decision-makers as they develop reimbursement policies for existing and novel products and services.

Our attorneys also work with a variety of state agencies to address licensing and certification issues for our clients, including Certificate of Need issues. We are dedicated to providing our clients with the most effective representation possible when any issue arises.