Compliance and Risk Management

Corporate compliance programs allow healthcare providers to take proactive action to mitigate risk of government fines and penalties. An effective compliance and risk management program involves strategic planning and a commitment to compliance.

In the current and evolving healthcare environment, providers must establish compliance programs as a condition of enrollment into Medicare and Medicaid. Failure to do so will put providers at risk of liability. Athene Law is well-versed in compliance law, risk assessments, training, audits, reviews, investigations, policies, and procedures. Our clients include hospitals and hospital systems, physicians and physician groups, networks, suppliers, pharmacies, and more, and we tailor each approach to a client’s specific needs.

Compliance Capabilities

Athene Law’s expertise spans a broad range of compliance law issues, including:

• Billing and coding
• Facility-physician relationships, including corporate practice of medicine and Stark compliance
• Patient and referral source remuneration issues, such as beneficiary inducements and the Anti Kickback Statute
• Corporate compliance/governance, including development and implementation of compliance plans
• Cost reporting
• Hospital operations
• Internal investigations and audits
• Licensing
• Managed care compliance, i.e., compliance with managed care contracts
• Medical staff
• Medicare and Medicaid coverage and reimbursement
• Scope of practice
• Self-referral analysis
• Self-reporting strategies
• Voluntary disclosures to governmental agencies