Leaders in healthcare innovation, Nelson Hardiman provides deep insights and strategic counsel on the new era of value-based care (VBC). Rapidly supplanting the waning “fee-for-service” era of volume-based reimbursement, we help integrative health systems manage risk and optimize VBC models in their practices.
We advise on risk management issues of data sharing and usage, reimbursement structures and cost controls, technological initiatives to facilitate patient engagement, and effective practice integration. Nelson Hardiman helps our integrative health systems clients identify risk and optimize value to efficiently realign and thrive in the brave new world of value-based healthcare.
Related PracticesGovernment InvestigationsLitigationRegulatory ComplianceTransactions
Our Work Includes:
- Business Transactions Advised on operational matters including corporate reorganizations, integrated health systems.
- Complex Business Planning and Negotiation Served as in-house counsel for several nonprofit integrated health systems advising on business planning and structuring, contract negotiations, and the broadest range of reimbursement and regulatory compliance and strategy.
- False Claims Act Civil fraud experience includes defending integrated health systems in complex federal and state FCA actions involving claims for allegedly non-reimbursable, unnecessary or inflated services and costs.
- Healthcare Factoring Structured factoring transaction for six healthcare providers and three investment firms involving $20 million in workers’ compensation accounts receivable in response to changes brought forth by California Senate Bill 1160.
- HIPAA Compliance Advised multiple integrated health systems on HIPAA privacy and data security breaches; implemented HIPAA compliance programs for numerous entities, including developing a patient data registry providing outcomes measurement and quality improvement.
- Medicare Compliance Advised digital health company on compliance and risk management strategy in servicing Medicare beneficiaries and contracting with Medicare and in-network healthcare providers.
- Stark/Anti-kickback Statute Negotiated and implemented a corporate integrity agreement on behalf of an integrated health system following federal investigation of Stark/Anti-Kickback Statute violations.