OUR HEALTH CARE FOCUS
Since 1922, Wilke Fleury has represented its health care clients in all aspects of their business operations and legal compliance. Whether an individual physician or large health insurer, we have the legal and professional experience to efficiently represent the health care entity with competent, effective and specialized legal services to compete in this highly regulated and changing industry. Our health care attorneys represent payors and providers in the following areas:
- Formation and initial licensure of health insurers, Knox-Keene health plans and MediCare Advantage Plans.
- Regulatory compliance and defense of government accusations before the California Department of Insurance, Department of Managed Health Care and Department of Health Care Services, including:
- All aspects of licensing compliance, from the filing of material modifications or plan amendments to gaining approval for plan subscriber documents.
- Representation during and following routine and non-routine audits, surveys and financial examinations.
- Defense of civil and administrative fines.
- Advice and representation of discount programs and plans.
- Defense of disciplinary and license revocation hearings before the Medical Board, Dental Board, Chiropractic Board and other professional licensing entities.
- Representation in contracted and non-contracted billing and payment reimbursement disputes.
- Medical malpractice defense of health care professionals, hospitals and long-term care facilities.
- Defense and representation in Qui Tam and False Claims Act and related health care offenses, including False Statements Act, Social Security Act, the “Stark” Statutes, Federal Mail and Wire Fraud and Civil Monetary Penalties Law.
- HIPAA and California privacy issues
- Mental health parity requirements
- Sale and acquisition of physician practices and medical groups
- Employment counseling and litigation
- Legislative advocacy
- Real estate transactions
- Tax matters
- Formation of tax exempt organizations
- California Alcohol and Drug Program matters
The Firm’s representative clients include HMOs, PPOs, indemnity plans, hospitals, skilled nursing facilities, medical groups, IPAs, individual physicians, pharmaceutical companies, biotech companies, medical equipment suppliers, health care trade associations and individual health care practitioners.