Health care providers, particularly Ambulatory Surgical Centers (ASCs), have unique, complicated legal needs. Potashnik & Associates is a leader at providing a wide variety of legal services to ASCs, capitalizing on our years of experience to provide you with the finest representation possible.

Practice Areas

We have a deep understanding of the regulations governing ASCs, and can therefore provide counseling on a number of issues that includes, but is not limited to:

• Fraud, waste, and abuse counseling, including compliance with the Stark law, Anti-Kickback Statute, and ASC Safe Harbor
• ASC development
• Joint ventures with doctors, hospitals, or health care systems
• Purchase or sale of equity interests
• Certificates of Need and licensing issues
• Compliance with HIPPA law, to include HIPPA privacy and breach notification issues
• Compliance with Medicare ‘s Conditions for Coverage and Conditions of Participation
• Coding and payment regulations related to Medicare and Medicaid
• Audits and appeals, particularly those pertaining to Medicaid, Medicare, RAC, ZPIC, and private payers
• Contractual and transactional agreements
• Operations, corporate governance, and structural issues
• Miscellaneous matters related to health care law or industry regulations

Legal Experience Related to Ambulatory Surgery Centers

Our team has a wide range of experience in a number of areas related to ASCs, with a few of the most prominent areas being:

ASC development and joint ventures with hospitals, physicians, or health systems -Joint ventures between hospitals, doctors, and other health care enteritis may appear on the surface to be a rather simple, uncomplicated process; however, that is hardly the case. Multiple compliance issues can arise if an ensuing transaction could result in one or more doctor/owners being able to obtain referrals from new physician/owners. Expert legal consultation is needed to avoid instances such as these, and our firm has the experience needed to provide you with skillful guidance.

Purchase and sale of ASCs and membership interests -Buying an ASC can be equally as complicated as a joint venture, and requires careful diligence to ensure the seller is compliant with all regulatory and Medicare claims submission requirements . Buyers must also be aware of the actions that must be taken in order to transfer Medicare billing privileges or certificates of need. Sellers must be concerned with a number of issues as well, such as the admission of members and voluntary and involuntary terminations related to the ASC “safe harbors.”Here at Potashnik & Associates, we advise clients on these things and more to ensure that buying or selling an ASC goes as smoothly as possible and that there are no legal issues to be concerned with.

Compliance Plans -Of particular concern to ASCs is Medicare’s Conditions of Participation and Conditions for Coverage. Our attorneys will advise you on these and other matters such as compliance with HIPPA, Medicare reimbursement regulations, Stark law, and federal anti-kickback statutes. We have extensive experience drafting documents, including privacy and security manuals that have been widely regarded in the industry.

Audits -Audits require an aggressive line of defense from a team who is very familiar with all stages of them, including the appeals process. Potashnik & Associates is a leading law firm in the areas of RAC, ZPIC, MAC, Medicare, Medicaid and third party payer audits. We also have extensive experience with the appeals process, and work diligently with clients through all phases of it. Our team will even advise clients who have been placed on payment suspension or pre-payment review. We provide an approach that is tailored to each client’s needs, and will draft written submissions and position papers especially for your case.

ASC Recent Focus Areas
Health care law is ever evolving, particularly when it comes to Ambulatory Surgery Centers. For this reason, it is important to know what recent experience a particular law firm has. Potashnik & Associates is proud of the fact that we have focused extensively on the following areas very recently:

• Compliance model arrangements
• Compliance with regulatory safe harbors and sales of equity interests
• HIPAA violations
• Out-of-network business with payers

Resources

For more information, please visit the Center for Medicare and Medicaid Services’ Ambulatory Surgical Center page by clicking here.

In-House Articles

In addition to being a leading health care law provider, the attorneys of Potashnik & Associates have also penned numerous articles relating to ASCs, which can be accessed at this link.

Speaking Engagements

Our attorneys are available to speak on a variety of issues pertaining to ASCs, including audits and health care law. Please contact our office if you are interested in having one of our attorneys speak at your event. To see a list of past speaking engagements, please click here.

Contact Us

We realize that you may still have other questions that have not been answered here. If so, we invite you to contact us here at Potashnik & Associates to schedule a consultation. We can be reached by phone at 212-577-6677, or by email at jp@jpolawfirm.com