Our attorneys advise pharmacies, health care providers, group practices, health care marketing companies, cannabis companies, and health care-related startups on legal compliance, regulatory compliance, and risk management. We also serve as defense counsel for health care-related audits and investigations, disciplinary actions, and administrative proceedings.
Helping Health Care Providers Maintain Compliance and Manage Risk
At Macaulay Jamerson & Sessa, we develop compliant yet realistic solutions. We focus on creating policies and procedures that your organization will actually follow instead of policies that look good on paper but are difficult to execute. Whether we are hired to develop a fraud, waste, and abuse compliance program or review an existing HIPAA policy, our goal is to ensure that our clients stay as far away as possible from a government enforcement action or fraud investigation.
Our services for health care providers include:
- Addressing day-to-day legal concerns related to compliance, operations, and practice management
- Developing and updating health care compliance policies and procedures
- Implementing compliance policies and procedures
- Conducting compliance training programs
- Conducting internal compliance audits and risk assessments
- Serving as defense counsel for audits and investigations
Compliance and Risk Management
There is no shortage of rules and regulations in the health care industry. We help our clients make sense of the laws governing their business and turn them into actionable tasks that ensure compliance. Our experience includes advising health care providers and other entities on compliance with applicable laws and regulations, including the following:
- Anti-Kickback Statute
- Controlled Substances Act (CSA)
- Eliminating Kickbacks in Recovery Act (EKRA)
- False Claims Act
- Health Insurance Portability and Accountability Act (HIPAA)
- Medicare and Medicaid rules and regulations
- Stark Law
- Other pertinent state and federal laws and regulations
Audit and Investigation Defense
We have significant experience representing health care providers and other entities in government health care audits and investigations at the state and federal levels. We represent clients in matters involving the U.S. Department of Justice (DOJ), U.S. Drug Enforcement Administration (DEA), U.S. Department of Health and Human Services Office of Inspector General (DHHS OIG), Medicaid Fraud Control Units (MFCUs), and the Virginia Department of Medical Assistance Services (DMAS). Learn more about our Government Investigations practice.
Disciplinary Actions and Administrative Proceedings
Macaulay Jamerson & Sessa has significant experience representing Virginia health care providers in state-level administrative matters. We provide representation for licensed health care professionals facing disciplinary actions and health care entities involved in administrative proceedings in front of the Virginia Board of Medicine, Virginia Board of Nursing, Virginia Board of Pharmacy, and beyond.