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In Brief: A Digest of Children's Hospitals and Pediatric Providers Projects
Client Success
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Consult on physician integration initiatives and collaborate with valuation experts to apply fair market value principles to pediatric employment, professional services and other affiliation arrangements.
Structure and develop pediatric provider networks designed for Medicaid managed care and/or commercial payor contracting.
Represent Medicaid providers in supplemental reimbursement Disproportionate Share Hospital (DSH) appeals and consult on Upper Payment Limit (UPL) program development.
Design and develop patient safety organizations unique to children’s hospitals.
Design, develop and evaluate compliance with federal research regulations (informed consent/IRB issues), NIH Grants Policy Statements, and federal investigations involving pediatric research.
Structure and develop subsidiaries and joint ventures to commercialize research developments by children’s hospitals.
Advise on intellectual property and software licensing matters relating to children’s hospitals and unique pediatric care technologies and procedures.
Provide counsel regarding GME matters, including community provider/educational institution affiliation models, funding and resident allocation considerations, resident and medical student supervision requirements and appropriate billing practices as they relate to teaching physicians and academic institutions.
Advise on day-to-day operational issues impacting pediatric providers such as consent, guardianship and child abuse/ neglect reporting requirements.
Provide guidance regarding regulatory compliance with the Stark Law, False Claims Act, Anti-kickback Statute, and reimbursement rules, with a focus on aspects unique to healthcare providers to children.
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