Navigating the complex landscape of healthcare regulations at both federal and state levels is a significant and often costly challenge for industry participants. The ever-evolving political climate only adds to the uncertainty surrounding the intricate regulatory framework that governs a sector relied upon by millions for critical care and support.

At Clinic Codes, our Healthcare Compliance and Regulatory Team provides clear, practical guidance to help healthcare organizations meet their legal and operational obligations. From licensure and certification to reimbursement and enforcement matters, we support clients across the spectrum of care—including hospitals, physician groups, pharmacies, ambulatory surgery centers, imaging facilities, health insurers, HMOs, TPAs, and other healthcare payors and providers.

Our team is experienced in managing all facets of compliance with federal and state regulations, including the Anti-Kickback Statute, the False Claims Act, the Stark Law (self-referral prohibitions), and applicable safe harbor provisions. We also defend clients in fraud and abuse investigations, audits, overpayment disputes, and enforcement actions brought by federal and state authorities.

Clinic Codes assists clients with drafting and implementing compliance policies and procedures, as well as conducting training programs related to HIPAA Privacy, Security, and Electronic Transactions standards—along with corresponding state laws. We also represent clients in HIPAA-related enforcement actions before the Office for Civil Rights (OCR).