Los Angeles and Southern California

Los Angeles and Southern California Healthcare Compliance Attorneys

As robust as the medical profession in Los Angeles and Southern California 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.

It 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 “strike force” to prosecute healthcare fraud in and around L.A.

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

  • The owner of a Los Angeles drug and alcohol treatment facility pleaded guilty to a $175 million healthcare fraud scheme. He was charged with seven counts of grand theft, five counts of insurance fraud and one count each of identity theft and money laundering.
  • Two Los Angeles pharmacy owners were sentenced for a multimillion-dollar scheme that billed $11.8 million in fraudulent medication claims to Medicare and Cigna.
  • A Los Angeles-based company that runs 27 nursing homes has agreed to pay $16.7 million to resolve allegations that they violated the False Claims Act by submitting false claims to Medicare for rehabilitation therapy services that were not reasonable or necessary.

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.

Is your Los Angeles or Southern California-based healthcare practice, durable medical equipment manufacturer, telemedicine company, or specialty healthcare clinic one of these?

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.
Los Angeles and Southern California

What Can My Los Angeles/Southern California 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 Los Angeles and the Southern California 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 Los Angeles and the Southern California 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 fraud and abuse laws, including:

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 Los Angeles and Southern California?

What Types of Healthcare Professional Does the Chapman Law Group Compliance Practice Serve in Los Angeles and Southern California?

We work with Los Angeles and Southern California 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
Los Angeles and Southern California

Chapman Law Group: Your Source for Healthcare Compliance Consulting and Representation in Los Angeles and Southern California

We are proud to serve licensed healthcare professionals in cities, counties, and communities all across Los Angeles and Southern California — Pasadena, Long Beach, Santa Monica, San Fernando Valley, San Bernardino, Anaheim, Irvine, Huntington Beach, Newport Beach, as well as Los Angeles County, Orange County, Ventura County, San Bernardino County, and Riverside County.

Besides Los Angeles and Southern California, we have offices in Detroit (where we serve Dearborn, Troy, Ann Arbor and Grand Rapids, and the rest of Michigan); Miami and Sarasota, Florida (for Jacksonville, Tampa, Orlando, West Palm Beach, and all of Florida); and Chicago

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

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