CAPABILITIES

Home Health

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Overview

Hooper, Lundy & Bookman understands the distinct nature of home health care services and the corresponding complexity of the legal and regulatory frameworks that govern home health providers and businesses. We work with clients nationwide to help them meet the growing needs of an aging population, positioning them for sustained success, maximizing payments and reimbursements, and minimizing costly and disruptive compliance issues.

With an exclusive focus on health care law and capabilities extending to every legal, regulatory, transactional, litigation, finance, and business issue facing home health providers, HLB can deliver comprehensive and efficient representation. Our clients span the home health and home care spectrum, including independent home care agencies, franchised home care agencies, Medicaid-waiver agencies, Medicare-certified home health agencies, and private duty nursing providers. We also work with clients on new and emerging home health delivery models, such as concierge care services, and assist rural health clinics with their provision of visiting nurse services to vulnerable populations. 

The explosive growth of this sector has been accompanied by expanding regulatory requirements and increasing governmental scrutiny. Similarly, scores of potential documentation, coding, and other missteps could threaten payments and reimbursement from Medicare, Medicaid, and other payors. HLB has been a recognized leader in compliance, fraud and abuse, and reimbursement matters since the firm’s founding in 1987. Our deep bench of experienced practitioners has the specialized knowledge of the law and home health industry needed to navigate these issues both proactively and after concerns arise. We also counsel on operations, contracting, corporate governance, mergers and acquisitions, asset sales, joint ventures, real estate transactions, and other business and financing matters.

HLB’s representation of home health providers and businesses includes: 

  • Medicare and Medicaid certification and recertification
  • Medicare and Medicaid documentation, coding, and payment compliance
  • Medicare Conditions of Participation and Conditions for Coverage
  • Face-to-face encounter, documentation, and physician signature requirements
  • Documentation requirements involving homebound status and skilled nursing services
  • Investigations, audits, and appeals involving Medicare, Medicaid, RAC, UPIC, OIG, and equivalent state authorities
  • HIPAA compliance and patient privacy matters
  • Outcome and Assessment Information Set (OASIS) issues
  • Assistance with accreditation surveys, corrective action plans, and termination appeals
  • Change of ownership (CHOW) or location issues
  • Contractual and transactional matters
  • Operations and corporate governance
  • Government investigations
  • Internal investigations
  • Compliance counseling and program development
  • Licensure issues
  • Fraud and abuse, Stark Law, and anti-kickback law counseling and defense