Health Care

Meliora Law’s health care team assists clients with regulatory, compliance, audit, and transactional legal matters.  We work with our clients to maintain compliance with the complex and often changing regulatory environment in which they operate.

Our team guides clients to navigate audits and investigations by government authorities, works to build robust compliance programs and processes to prevent noncompliance at the outset, prepares self-disclosures when issues are identified, and provides ongoing regulatory advice and guidance.  We also collaborate with other law firms, consultants, and CPAs to advise them and their clients on health care regulatory and compliance matters, including due diligence review and audits.

Our health care team provides an array of health care compliance and audit services on flat fee and other flexible fee arrangements, including:

Compliance Plan Package:  We work with clients to develop a compliance plan or review, revise and update their compliance plans in accordance with the requirements of the Office of the Medicaid Inspector General (“OMIG”) set forth in 18 NYCRR Part 521-1 and the self-disclosure regulations set forth in 18 NYCRR Part 521-3, as well as Medicare requirements and Office of the Inspector General (“OIG”) guidance. This package includes a compliance plan, standards of conduct and Deficit Reduction Act policy, as well as corporate documentation necessary to formally adopt the revised plan.

Compliance Training Package for Governing Body/Senior Staff:  We develop and provide compliance training to the governing body and senior staff, either in person or via web conference.  This package includes a copy of compliance training materials and a post-evaluation effectiveness tool.

Compliance Training Package for Front-Line Staff: This package is available in tandem with the Governing Body/Senior Staff training or as a standalone package, and includes the development of either (1) written training materials or (2) a pre-recorded web-presentation appropriate for training front-line staff.

Compliance Program Effectiveness Review: Providers subject to the OMIG Compliance Program requirements are required to conduct an annual effectiveness review of their compliance program.  We provide an independent compliance program effectiveness review which includes:  (a) review of the existing compliance materials; (b) an assessment of the adequacy of documentation of the implementation; and (c) the effectiveness of the plan as measured by key metrics. A final report is prepared summarizing the results of the review, identifying strengths of the compliance program and any gaps in the compliance program’s structure or functioning. The final report includes recommendations for addressing identified gaps and strengthening the program.  Providers may elect to also have the results of the Compliance Program Effectiveness Review shared with the governing body and senior management at an in-person or web-based presentation.

Compliance Work Plan Package:  We work with clients to assist them in the development of a compliance work plan, training plan, and audit plan as required by 18 NYCRR Part 521-1.  This package includes a work plan template and assistance in populating the work plan in a manner that best meets the needs of the organization.

Assistance with Internal Audits:  We work with compliance officers to develop the scope of an internal audit, conduct the audit, assess any findings and determine appropriate corrective action, if necessary.

Meliora Law’s approach to representing clients in health care transactions is designed to bring the Firm's experience with tax, structuring, liability mitigation, corporate law and transactions, and health care together to inform and guide all aspects of a deal, from structuring and negotiations, through to document preparation and review, due diligence, licensing, and closing.