Healthcare Law for Nonprofits

Healthcare is a diverse, heavily regulated, and high-risk business. Venable's extensive experience with all sectors of the healthcare industry provides perspective to assist its nonprofit clients in all matters affecting the industry. For more than 40 years, Venable has assisted clients with federal and state regulatory healthcare compliance, including the False Claims Act, Stark compliance, and fraud and abuse investigations. In addition, we advise clients on issues involving HIPAA privacy and security matters, insurance and risk management, the practice of medicine, and unfair business practice restrictions.

Venable's experience includes federal and state Medicaid and Medicare regulatory issues and general contract terms associated with private payor or reimbursement contracts. We have counseled clients regarding the government payment programs, including extensive work on ways to establish reimbursement lawfully in situations such as joint ventures and corporate restructuring, including administrative reviews and judicial appeals. This work has involved certification, conditions of participation, coverage, reassignment, and other reimbursement issues for all types of government-certified providers.

Venable closely monitors changes in the laws and regulations that influence or affect our clients. We help our clients to comply with the maze of regulations that dictate how to manage daily operations, billing, purchasing, and other key functions. When needed, we have the depth and experience to defend clients in criminal, civil, and administrative proceedings with government or private payors that stem from reimbursement contract disputes, and to advise them in audits or investigations.

Our practice includes licensure and certification for hospitals and healthcare professionals in many specialties before state licensing boards. We assist with patient care practices, including the process of informed consent to treatment.

We also regularly advise nonprofit organizations about the group health plans that they offer to their employees, or that association members may be offering to their own employees.

Even in the wake of national health reform, health insurance plans for employees continue to remain a highly valued benefit for employees. We have advised organizations about the HIPAA, COBRA, mental health parity, GINA, and regulatory developments affecting the design and structure of health and welfare plans, and have worked with organizations to structure retiree health obligations and take advantage of potential subsidy programs.

In addition, we regularly advise clients about the myriad of nondiscrimination testing, reporting, disclosure, and other legal compliance obligations that arise with health plans for employees. We work hand in glove with our clients and their HR staffs to implement efficient and effective open enrollment processes, negotiate contracts with health and welfare vendors to be sure they get the support services they need, and integrate and streamline health and welfare benefit programs in order to help them save money.

Now that national health reform has become a reality, the health insurance market for nonprofit organizations, their employees, and their members will be changing dramatically in the next few years. Venable will be working with its nonprofit clients in helping to evaluate all of the options that will be available to them, so that they are able to make the right choices that are in the best interests of the organization, its employees, and its members.