The healthcare industry is subject to a maze of statutes and regulations. Providers, manufacturers, and distributors are subject to increased government scrutiny, making compliance an on-going challenge. We combine our intimate knowledge of the healthcare industry with our legal expertise to help you navigate the maze and achieve your goals.
While challenging to navigate, regulatory changes, such as the Accountable Care Act, have spurred innovation in healthcare, resulting in a plethora of healthcare-related startups. Yet, many founders struggle to understand the regulatory landscape. We welcome the opportunity to counsel startups as to if, when, and to what regulations they may be subject.
Healthcare-related areas in which PNW Strategic Legal Solutions provides guidance:
Healthcare Law For Patients
Medical Insurance Claim Denials
- refuses to pay for part or all of a service that is a benefit under your plan
- claims you are not eligible to enroll in the health plan
- reduces or terminates a covered service that you have been receiving under your plan
- claims the care is not medically necessary
- claims the treatment is experimental or investigational
- asserts you are not eligible for a certain benefit
Time LimitsClaim denials must be appealed within a certain time period! So, contact us as soon as you receive a denial to allow us sufficient time to review your claim, gather needed documents, and craft a robust appeal.
Healthcare Law For Providers
- Disciplinary defense, including complaints, investigations, and audits such as those conducted by the Washington Department of Health (DOH), Medical Quality Assurance Commission (MQAC), Dental Quality Assurance Commission (DQAC), and mandatory reporting to the National Practitioner Data Bank (NPDB)
- Practice purchase and sale
- Compliance with federal and state healthcare regulations and law, including physician self-referral restrictions under Stark, Health Information Portability and Accountability Act (HIPAA), scope of practice under state law, and more
- Comprehensive employment contract review, including non-competes
- Payor reimbursement rate negotiation and contract review, including modeling
- Review of healthcare startup plans for compliance
We know you’re worried.
Have a question? Concern? Request?
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