Kronick’s Health Care team understands both the complex and ever-changing regulations imposed on our clients as well as the business of providing health care services. Because our lawyers focus exclusively on one industry, namely health care providers such as FQHCs, community clinics, rural clinics, physicians and physicians’ groups, and skilled nursing homes and senior living facilities, they provide practical advice on how best to navigate complex regulatory issues and minimize the risk of any future issues.
Kronick provides legal support and representation to health care providers such as:
- 340B advice and compliance
- Clinic accreditation and qualification
- Clinic expansion efforts
- Compliance program review and analysis
- Corporate Compliance Policies drafting and implementation
- Defense of license revocation actions
- Develop Corrective Action Plans
- Enterprise structure and governance and business and corporate reorganizations
- False Claims Act defense
- Health care regulatory due diligence
- HIPAA, privacy and data security compliance
- Internal investigations
- Investigating potential overpayments
- Joint ventures
- Managed care contracting and compliance
- Management services agreements
- Medi-Cal Reconciliation and PPS scope change audits and appeals
- Medicare and Medicaid billing issues and audits
- Medicare and Medicaid reimbursement issues
- Mergers, acquisitions, and divestitures
- Representation before licensing boards
- Risk management
- Security breach notifications
- Self-Disclosure of potential overpayments
- Stark and anti-kickback compliance & analysis
- State licensing and regulatory matters
- Whistleblower and qui tam actions
Over the past three decades, Kronick’s Health Care Practice has focused on supporting business and clinical transactions between medical groups, health systems and/or health plans. The focus has been on the formation of transactions that result in workable relationships that are designed to improve clinical care delivery including the design of integrated delivery system arrangements and building the infrastructure necessary to support these arrangements. Types of transactions include:
- Building and Implementation of Integrated Delivery System Arrangements
- Capacity Build Acquisition/Merger Transactions
- Design of Hospital Physician Networks
- Health System Financing Transactions
- Support of Realignment of Health Plan Provider Contracting Strategies
- Supporting Major Transactions Involving Medical Group Strategies
The attorneys in our health care practice are committed to serving the legal needs of FQHCs, RHCs, skilled nursing facilities and other health care providers who provide ambulatory care to their patients. Our health care team has substantial expertise and experience in handling all aspects of operating an FQHC or RHC, including the grant application process, governance, structuring affiliations and collaborations, contracting, and state and federal compliance requirements for FQHCs and RHCs.
The past year presented unprecedented changes for all health care practices in light of the COVID-19 pandemic. Our health care team strives to keep all clients informed with the most up-to-date information as to any new laws, issues, and compliance practices as they arise. We maintain a practice of researching and reporting any new laws and new issues that face our clients and we endeavor to find the most efficient and practical means to answer all questions and concerns about the myriad of new policies that the industry faces.
As a full-service firm, Kronick provides strategic support to our clients in a wide range of business transactions that must take into account considerations that are unique to the health care field, including HIPAA and privacy issues, security breach notice requirements, reimbursement, antitrust, tax, and a myriad of local, state and federal regulations impacting health care providers.
Our experience includes transactions involving nursing homes, hospitals, physician groups, health plans, ancillary service providers, assisted-living facilities, pharmacies and pharmacy benefit management companies, ambulatory surgery centers, independent diagnostic testing facilities, provider networks, and medical device manufacturers.
Our attorneys assist our clients in all stages of an audit, investigation, or administrative dispute. These include supporting them with both internal and external investigations, protecting client interests throughout the audit process, and representing them in administrative hearings regarding reimbursement and compliance. Additionally, our firm provides legal support and representation to clients with cases pertaining to the Anti-Kickback Statute, Stark Law, and False Claims Act, and Medicare/Medicaid enforcement actions.
Our clients operate in Los Angeles, the San Francisco Bay Area, Sacramento Valley, San Joaquin Valley, San Diego, Orange County, Inland Empire and the Central Coast.
People
Publications
Newsroom
- Licensing Considerations for CFOs & Hot Topics in Healthcare Compliance for Intermittent Clinics: There have been many changes to the process of establishing intermittent clinics in the past year, which have generated questions around changes in scope and PPS. The session provides an overview of emerging trends impacting healthcare regulatory compliance for intermittent clinics, including false claims act liability, licensing and enrollment issues, billing pitfalls, and increased regulation.
- Trust Is Not An Internal Control: Embezzlement Schemes and Basic Internal Controls: Internal controls prevent embezzlement and billing fraud but can be a challenge to implement in smaller organizations. We will discuss common embezzlement schemes and how to prevent or catch them early as well as steps to take with regulators regarding self-disclosure and corrective action plans.
Speaking Engagements
10.13.2023
|Speaking Engagement
|Creating a Competitive Advantage by Adding Additional Service Lines
Date
October 13
Location
Los Angeles
Kronick is pleased to sponsor the California Primary Care Association (CPCA) Annual Conference on October 12-13 in Los Angeles. Shareholder Jennifer Scott will participate in a panel discussion “Creating a Competitive Advantage by Adding Additional Service Lines.” This session describes how to legally add an additional service line to your FQHC practice such as hiring employees or entering provider contracts for services. We will analyze and assess the practical benefits of adding an additional service line to improve financial and operational practices and to create an integrated care setting. This session also provides real-life examples of how FQHCs have implemented chiropractic services, including examples of the types of conditions treated at FQHCs. To learn more and to register, please visit the event website.
05.21.2021
|Speaking Engagement
|Telehealth Billing Pitfalls and Best Practices – From Pandemic to Future Framework
DATE
May 17-21, 2021
LOCATION
Virtual
OVERVIEW
Kronick Shareholder Jennifer Scott will participate in a panel discussion about the rules and regulations related to telehealth visits, examples of what pitfalls to avoid, best practices to ensure reimbursement from Medi-Cal/Medicare, and how to incorporate into your reconciliation requests. As well as what to do if you have billed for a telehealth visit that you shouldn’t have and what changes to telehealth are coming down the pipe and how best to comply with these changes to the regulations. Please visit the event website for more information and to register.
08.21.2020
|Speaking Engagement
|California Primary Care Association’s Billing Managers and CFO Conference
Date
August 17 – 21
Location
Virtual
Overview
The California Primary Care Association’s Billing Managers and Chief Financial Officers Conference provides an exchange of information, problem-solving, and training for community health centers (CHCs). Kronick Senior Counsel Jennifer Scott will be participating in two-panel discussions: “Licensing Considerations for CFOs & Hot Topics in Healthcare Compliance for Intermittent Clinics” and “Trust is Not an Internal Control – Embezzlement Schemes and Basic Internal Controls.”
05.17.2019
|Speaking Engagement
|FQHC Regulatory Constraints and Growth Opportunities
Date
Friday, May 17th
Location
San Diego, CA
Overview
The California Primary Care Association’s Chief Financial Officers Conference provides an exchange of information, problem solving, and training for community health centers (CHCs). Kronick attorney Jennifer Scott will be participating in a panel discussion addressing the difference between a Scope of Project and a Scope of Service and its impact upon revenue cycle management of FQHCs.