HEALTH CARE

We are committed to helping you assess and avoid risk, while minimizing disruptions to your business.

We believe in helping those who help others and we believe this is best exemplified in the legal services we provide to health care professionals and providers. Our health care attorneys advocate for health care professionals, hospitals, long-term care facilities, skilled nursing facilities, psychiatric hospitals, group homes, dialysis clinics and private practices in a number of different settings. With experience in cases involving professional negligence, licensing board investigations and hearings, regulatory compliance issues and appeals, False Claims Act, HIPAA matters, and contracts, including non-competition agreements, our health care team has successfully defended physicians and other health care providers in medical malpractice lawsuits as well as in state licensing, grievance and disciplinary proceedings.

In addition to being advocates for our clients, our attorneys are also counselors. We understand the business challenges that medical and health care professionals face every day. We bring a deep commitment to helping our clients achieve success in their own practices by using our diverse legal experience to help them assess and avoid risk. We advise our clients regarding the development of policies and procedures, risk management programs, business transactions, and employment law matters. Our experience includes state licensing board investigations, employment counseling, employee termination and discipline, discrimination and harassment claims, wage and hour issues, development and review of employee handbooks, and business matters such as medical practice formation and dissolution.

Billing and Reimbursement

Though obviously important for any healthcare provider or practice, a practice’s billing and reimbursement procedures can often form an overlooked source of potential risk. We advise our clients on policies and procedures to ensure adequate documentation of medical necessity as required by payors in order to receive reimbursement without fear of future audits. To support our clients, we perform internal audits that review charge accuracy and medical necessity. We also represent our clients in denial appeals against both private and public payors and work on issues of preferred payors agreements.

Credentialing and Licensure

As professionals, the ability to obtain and maintain licensure is critical.  Our attorneys regularly appear before all the healthcare licensing boards with particular familiarity with the North Carolina Boards of Dentistry, Medicine, Social Work, Speech Language Pathology and Psychology.  We help applicants to obtain new licensure, including licensure by credentials, and to seek reinstatement of suspended or revoked licenses.  We also represent health care professionals who receive patient complaints to their respective Boards or are subject to other Board investigations, including those arising from fraudulent billing allegations.  In addition, we have experience representing hospitals in cases of negligent credentialing and use that experience to assist clients seeking to obtain credentials.

False Claims Act

Medicaid is a rapidly expanding source of health care coverage for many patients. Our attorneys have experience handling qui tam actions as well as actions brought by the Department of Justice, the Attorney General, and the Department of Health and Human Services. We help our clients navigating the complex layers of federal and state enforcement agencies while also strategically preparing for potential licensing issues that can arise from suits arising from the False Claims Act.

Practice Management

Regardless of the clinical setting in which health care providers practice, they face a wide array of challenges in forming and running their practice. We leverage our knowledge of the complex laws and regulations governing health care professionals’ business operations to help our clients focus on their patients rather than their business. Our attorneys and our associated professionals help health care professionals to form practices, hire qualified staff, comply with state and federal law and regulations, all while striking the balance between advancing office technology and proper record keeping requirements. We also assist our clients in performing internal audits, developing administrative and clinical policies and procedures, and navigating the employment issues facing healthcare practices.

Professional Negligence

Being named as a defendant in a lawsuit alleging professional negligence is profoundly stressful and disruptive to any health care provider.  The process can be long and sometimes confusing.  Our attorneys bring the experience and wisdom of seasoned trial lawyers to each case.  We have defended numerous medical specialties in cases involving serious injury and death, including birth injury and brain damage cases.  We have the expertise and the connections to hire the best experts to provide early and accurate evaluations of each case and to help us formulate the most effective defense strategy.  Moreover our experience with licensing boards and regulatory issues allows us  to understand the interplay between professional negligence litigation and other areas of concern that affect our clients and their practices.

J. Matthew Little
Jennifer B. Milak

Obeying the Unwritten Rules

Walker v. North Carolina State Board of Dental Examiners and Its Meaning for Professional Licensees in North Carolina North Carolina currently has fifty-five occupational licensing agencies. These agencies regulate professions including law, medicine, engineering, surveying, therapy, and real estate. Generally, the…

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Affirmative Duty of a Dentist to Self-Report Adverse Occurrences

Some dentists and all oral and maxillofacial surgeons utilize general anesthesia and sedation in their practices.  These are wonderful tools to help dental professionals provide care to their patients but unfortunately, the use of anesthesia and sedation carries risks and sometimes patients do experience adverse outcomes as a result.  The North Carolina Dental Practice Act spells out certain circumstances where a licensee must affirmatively report adverse occurrences related to the use of anesthesia and sedation.  It is important to note that the rule imposes a timeline of as little as 72 hours in which to report an adverse occurrence if it results in patient death.  Adverse occurrences which do not result in death must still be reported within 30 days.  The rule is set forth in 21 NCAC 16Q. 0703.

Delegation of Duties by a Dentist

Many dentists are concerned about what functions they may and may not delegate to a dental hygienist.  The Dental Practice Act spells those out activities that may be delegated in 21 NCAC 16G. 0101.

It’s important to note that even these delegable duties must be performed under the “direct control and supervision of a dentist.”  It’s also important to review those functions which cannot be delegated.  These are found in 21 NCAC 16G. 0103.

Obtaining a Dental License by Credentials

Dentists who have already obtained a license to practice in another state have the ability to apply for a North Carolina Dental License based on credentialing or reciprocity.  The process is far less time consuming and burdensome than obtaining a license as a new licensee. However, there are limitations on when an already-licensed dentist may obtain North Carolina licensure in this fashion.  The keys include having had a valid license to practice for a minimum of 5 years with a “clean” record.  A copy of the rule governing licensure by credentials can be found here.