Detroit Healthcare Compliance Attorneys

As robust as the medical profession in Detroit and around Metro Detroit is, the diversity and density of its populations make it one of the top five regions in the U.S. for healthcare fraud. It is identified by federal, state, and commercial payors as hot spots for healthcare transactions and services that do not adhere to laws and regulations.

Detroit has one of the highest rates of federal healthcare fraud indictments in the country — so much so that, since 2010, the U.S. Department of Justice (“DOJ”) has operated a Detroit-specific “strike force” to prosecute healthcare fraud in and around Metro Detroit.

Some providers are billing for items or services not rendered or not provided as claimed, double-billing, or misusing provider identification numbers, resulting in improper billing. Others are submitting claims for equipment, medical supplies, and services that are not reasonable or necessary.

In recent months, federal agencies have gone after several healthcare fraud schemes:

It’s not just the feds who have a vested interested. The State of Michigan runs a Health Care Fraud Division (HFCD) to identify, prosecute, and prevent fraudulent activity by doctors, dentists, pharmacists, and other healthcare providers participating in the Medicaid program. Since its inception, the HCFD has obtained criminal restitution orders totaling nearly $19.5 million and civil judgments at more than $407 million. In total, the HCFD has obtained court orders and settlements requiring the return of over $426 million to the Medicaid program.

Is your Detroit- or Metro Detroit-based healthcare practice, durable medical equipment manufacturer, telemedicine company, or specialty healthcare clinic susceptible of being targeted next?

Then you need to call the national healthcare compliance attorneys at Chapman Law Group immediately. But first, you need to understand why healthcare compliance is needed for your practice in the first place.

What Exactly is Healthcare Compliance?

Healthcare compliance is a system of processes, policies, and training that conform to state and federal laws and regulations that dictate the delivery of healthcare services and supplies.

All healthcare providers that bill Medicare, Medicaid, and/or commercial insurers are required to provide comprehensive and compliant claims for all services rendered and for all supplies/pharmaceuticals used in the delivery of patient care.

What Are the Penalties for Healthcare Fraud and Non-Compliance?

Using state-of-the-art observation techniques, comprehensive data analytics, and auditing, federal and state investigators are savvy at identifying healthcare providers that file false claims under Medicare, Medicaid, or private insurance.

And the penalties for non-compliant claims are severe:

  • Criminal prosecution.
  • Medical license suspension or revocation.
  • Civil and administrative enforcement can result in significant monetary fines and sanctions
  • Termination from all state Medicaid programs.
  • Loss of hospital privileges.
  • Exclusion from health insurance provider panels.
  • Exclusion from all federally funded program beneficiaries (e.g., Medicare, Medicaid, or TriCare enrollees).
  • GSA exclusion (debarment) from federal contracts.

What Can My Detroit Healthcare Practice Do to Assure Healthcare Compliance?

With an effectual compliance program in place, healthcare practices take a proactive measure toward regulatory and legal adherence.

A compliance plan protects healthcare professionals and medical practices from administrative, civil, and criminal penalties imposed by federal and state governments, as well as from payment reviews and network exclusions.

When a plan is place, everyone at the healthcare practice will know how to identify and correct improper claims through a custom auditing and monitoring procedure. With employees responding to suspected issues in a timely manner by following the compliance plan, that healthcare organization may prevent a formal investigation from ever happening at all.

And, should a private insurer or government agency investigate and prosecute healthcare fraud, having a comprehensive compliance program prior to the offense will reduce that healthcare practice’s culpability score, fines, and penalties.

Why Choose Chapman Law Group for Medicare and Medicaid Compliance Representation and Program Development in Detroit and the Southeastern Michigan region?

As lawyers whose sole client base is the healthcare profession, we at Chapman Law Group represent healthcare providers, medical suppliers, and related facilities against claims of conducting the business of healthcare operations in a non-compliant manner.

With our strong background in healthcare regulatory strategies and audit process representation, we know how to best prepare an appropriate defense to any allegations of non-compliance by government regulators or commercial insurers.

Our healthcare compliance lawyers have a unique understanding of the Detroit healthcare market. We are well-versed in compliance-related laws and regulations that can prevent an organization or provider from caring for a particular population of patients — or operating at all.

We work to establish, assess, and update a healthcare practice’s compliance program. These plans assist in identifying and preventing erroneous and fraudulent claims, eliminate billing mistakes, reduce the chance of a payor audit — and, most of all, serve as a proactive measure toward regulatory and legal adherence.

Additionally, the national attorneys at Chapman Law Group help startup and existing healthcare providers, suppliers, and facilities identify regulations, laws, and risks — all of which could affect a healthcare provider’s business before the doors are first opened.

Chapman Law Group’s legal experience and industry partnerships make us an excellent provider of Medicare and Medicaid compliance services. Our medical compliance attorneys work to find your claim weaknesses and correct them before Medicare/Medicaid discover the problems.

We are skilled at assisting clients with the highest risk area identified by the OIG: claims coding and billing. We can help you with claims compliance by prospectively addressing billing issues, whether related to missing charges, unstated procedures, inaccurate and non-compliant charging, or National Correct Coding Initiatives (NCCI).

Chapman Law Group helps to make sure that medical practices, through appropriate coding and claims submissions, do not run afoul of the five main federal fraud and abuse laws:

Chapman Law Group’s analysis of your charges/claims will pinpoint erroneous charges and identify whether non-compliant charging practices exist. Because of this rigorous process, we can review documentation relative to charges posted, provide real-time feedback to clinical staff, and work to correct documentation.

Our multidisciplinary healthcare compliance team is made up of highly skilled lawyers. One of our lawyers is a former HHS/Medicare attorney, while another is a former Medicaid Fraud Prosecutor. Additionally, each of our healthcare compliance attorneys holds, or is a candidate to receive, a Masters of Law in Health Law (LL.M.) post-graduate degree from Loyola University Chicago School of Law — the top school in the U.S. for Health Law.

What Services Does the Chapman Law Group Compliance Practice Offer to Healthcare Businesses in and Around Metro Detroit?

What Types of Healthcare Professional Does the Chapman Law Group Compliance Practice Serve in Detroit?

We work with Detroit and Southeastern Michigan medical providers and medical practices who are reimbursed by government (Medicare, Medicaid, TriCare) or commercial insurance payors, including:

  • Acupuncturists and Alternative Physicians/Providers
  • Addiction/Substance Abuse Treatment Clinics
  • Ambulatory Surgery Centers
  • Athletic Trainers
  • Assisted Living Facilities and Owners/Administrators
  • Audiologists
  • Behavioral Therapists
  • Chiropractors
  • Correctional Facility Healthcare Providers
  • Cosmetologists
  • Counselors
  • Dentists and Dental Hygienists
  • Dietitians and Nutrition Experts
  • Doctors/Physicians
  • Durable Medical Equipment Providers
  • Group Practice Specialists
  • Home Health Agencies and Owners/Administrators
  • Hospices and Hospice Owners/Administrators
  • Laboratories (CLIA certified and other)
  • Licensed Professional Counselors
  • Licensed Social Workers
  • Marriage and Family Therapists
  • Massage Therapists
  • Medicaid Contractors
  • Medical Assistants
  • Medical Spa Owners
  • Mental Health Professionals
  • Non-Traditional Healthcare Providers
  • Nursing Homes and Owners/Administrators
  • Occupational Therapists
  • Ophthalmologists
  • Optometrists
  • Pain Management Physicians/Specialists and Pain Clinics
  • Pharmacists and Pharmacy Technicians
  • Physical Therapists
  • Podiatric Medical Professionals and Surgeons
  • Psychologists (Limited and Full-Licensed)
  • Respiratory Care Workers
  • Sanitarians
  • Speech/Language Pathologists
  • Uninsured/Allied Healthcare Providers
  • Urgent Care Facilities
  • Veterinarians

Chapman Law Group: Your Source for Healthcare Compliance Consulting and Representation in Detroit, Southeastern Michigan, and All of Michigan

We are proud to serve licensed healthcare professionals in cities, counties, and communities across Detroit and Metro Detroit, including Ann Arbor, Dearborn, Sterling Heights, and Troy, as well as Oakland County, Wayne County, Macomb County, Washtenaw County. In addition, our healthcare compliance lawyers work with practices statewide, such as Grand Rapids, Lansing, Flint, Saginaw, Midland, Muskegon, Bay City, and Kalamazoo.

Besides Detroit, we have offices in Miami and Sarasota, Florida (for Jacksonville, Tampa, Orlando, West Palm Beach, and all of Florida); Los Angeles and Southern California; and Chicago

Contact us today to learn more about what can do for your healthcare compliance needs.

Need an Attorney? Contact us now!

.

  • This field is for validation purposes and should be left unchanged.

.

  • This field is for validation purposes and should be left unchanged.

Got A Question?

Contact me now to schedule a consultation.

Other Practice Areas​

Compliance

Related Case Results

FREE Health Care Newsletter

Stay up to date on the latest news in health care law!

Got A Question?

Contact me now to schedule a consultation.

Send this to a friend