Epstein Becker & Green, P.C.

Navigating the complex landscape of health care regulatory issues is essential for ASCs to remain compliant and competitive. EBG has extensive experience in federal and state regulatory matters and the distinct laws and rules applicable to ASCs. Since a vast majority of states require ASCs to be licensed in order to operate, they rely upon us to follow and understand those laws and rules in each applicable state to ensure that the specific requirements ASCs must meet for licensure and certificates of need are met, updated, and compliant. Additionally, since all ASCs serving Medicare beneficiaries must be certified by the Medicare program, we assist our clients in demonstrating compliance with Medicare standards initially and on an ongoing basis. We also help guide ASCs through reimbursement issues, billing and coding accuracy, and HIPAA compliance.

EBG’s attorneys advise multiple parties in developing new ASCs, including preparing corporate agreements and ASC licensure applications. We also advise ASCs and their owners on strategic transactions, including joint ventures and sales to hospitals, national ASC companies, and private equity partnerships. Our attorneys leverage extensive knowledge of federal and state health care regulations to provide practical solutions that help practices thrive in a rapidly evolving industry. As a trusted partner, we support ASCs and their executives with comprehensive transactional knowledge, business advice, reviewing major agreements, and navigating state and federal regulatory approvals needed for transfers of ownership of ASCs.

For decades, ASCs have been a target of government scrutiny in the area of healthcare fraud and abuse. We have advised dozens of ASCs on complying with OIG’s ASC Safe Harbors, in connection with the development of new centers (and their governance documents), and also with respect to redemptions and other buyouts of owners. The enforcement environment continues to evolve as new laws are passed, new regulations are promulgated, new cases are tested in the courts, new government settlements take place, and, perhaps most importantly, new approaches to the delivery of, and payment for, care are designed.

As ASCs face government scrutiny, our health care litigation team (consisting of many former federal prosecutors) excels in defending against government audits, and also pursuing disputes with payors (denials, down-coding, etc.), and handling complex commercial litigation with partners and major vendors. We also have a track record of success in defending fraud and qui tam False Claims Act cases, government investigations and inquiries, and administrative proceedings. Further, we have achieved very favorable rulings settlements for our ASC clients in pursuing amounts not paid by aggressive commercial payors.

We support ASC medical staff management by understanding the complex relationships between physicians, other health care organizations, and the laws and regulations on medical staff issues such as bylaws, and regulations, peer review, corrective actions and provider reporting. We help ASCs customize and manage their medical staff governing documents and general medical staff structure. Our attorneys also have extensive experience in managing the legal issues surrounding credentialing and peer review recommendations.

EBG’s Employment, Labor & Workforce Management practice helps employers (including multiple ASCs) navigate complex wage and hour compliance, ensuring adherence to federal, state, and local laws. We also advise on proactive compliance with harassment and discrimination laws and, if needed, conduct internal investigations, recommend remedial actions, and defend clients in court to protect their reputations. Our experienced team supports ASCs in navigating the evolving legal landscape impacting non-compete arrangements. We also address issues such as unionization and workplace violence.