Frequently Asked Questions

Our client, a Doctor of Dental Surgery, was the subject of a multi-state investigation that spanned nearly three years. The time and operational drag on the business arising from these investigations was significant, but the Prosecution Division of the Pennsylvania Department of State's Office of Chief Counsel recently closed their file on this matter with no further action or licensing implications.

Telemedicine is an Enforcement Risk Factor

Using our background as former prosecutors, federal investigators, and government regulators, HLA advises a wide spectrum of clients across the healthcare delivery chain on how to take risk in a safe and compliant manner.

Although there a number of factors that potentially increase risk in the highly regulated healthcare industry, the Department of Justice and supporting agencies, such as HHS-OIG and the FBI, have prioritized civil and criminal investigations relating to telemedicine in recent years.

Telemedicine is often the subject of federal focus because it typically crosses state lines and involves relatively high claim volume.

HLA's Defense Strategy

In this case, we helped the investigative agencies to understand the telemedicine space in great detail, which provided context for our arguments that the client's business model was fully compliant with all applicable laws and regulations.

In the healthcare industry, there is a lot of "grey," which provides for innovation and business opportunities. At the same time, if you or your business are seeking to capitalize on those opportunities, it is critical to have a compelling narrative that will address any regulatory concerns in the event of scrutiny. Reliance on experienced defense counsel often helps to support that narrative.

State Officials Declined to Prosecute

Based on our factual and legal arguments, multiple state licensing boards, including the Pennsylvania Department most recently, declined to take further action and closed their file. Now our satisfied client can refocus his energy where it should be, on running his business.

MORE ARTICLES BY CATEGORY

Get a Free Consultation

100% Confidential & Secure. Your details are safe with us.

We'll speak soon!

In the meantime, why not find out more about us or visit our blog.

Alternatively, give us a call at (800) 345 - 4125

Oops! Something went wrong while submitting the form.

Health Law Alliance Welcomes Compounding Expert Pharmacist-Attorney Dr. Martha Rumore as Of Counsel

Health Law Alliance adds powerhouse Pharmacist/Attorney Dr. Martha Rumore to their team of boutique healthcare attorneys.

Read More >>

Why Even Minor Documentation Errors Can Be Costly for Pharmacies Facing a PBM Audit

PBMs are using rigid documentation standards to recoup payments and pressure pharmacies. Minor clerical errors can now threaten reimbursement and network participation.

Read More >>

The Hidden PBM Threat Putting Pharmacies at Risk: Affiliation-Based Network Terminations

PBMs are quietly expanding their power, terminating pharmacies based on affiliation rather than wrongdoing and putting entire businesses at risk overnight.

Read More >>

Health Law Alliance Successfully Defends a New York Pharmacy in an Optum Audit

Facing an Optum PBM audit that threatened network participation, a New York pharmacy turned to Health Law Alliance for strategic legal guidance, resulting in a successful audit resolution and uninterrupted network status.

Read More >>