Mental Health Professionals
Psychologists, psychiatrists, and other mental health professionals face a multitude of professional and legal obligations. Our health care lawyers and compliance consultants can help make sure your mental health practice is ethically and legally sound.
Oberheiden, P.C. represents mental health professionals in all aspects of ethical and legal compliance. Whether you are preparing to open your own practice, you need to update your practice’s compliance program, or you are facing a Medicare audit or ethics investigation, we can provide the information, insights, and documentation you need to ensure that you license to practice is secure. Our team of federal health care lawyers and compliance consultants offers centuries of relevant experience; and, with proven results in compliance matters, audits, investigations, and federal civil and criminal trials, you can feel confident knowing that our team is on your side.
Just as no two mental health practices are exactly alike, no two sets of circumstances call for exactly the same legal advice. We custom tailor our advice and representation to our clients’ unique circumstances, from the patients they treat and the federal programs they bill to the location, size, and scope of their practices. When you choose Oberheiden, P.C. as your health care legal counsel, you will always work one-on-one with the senior attorneys on our staff, and you will have direct access by phone, text, and email whenever you need to get in touch. Our mental health practice encompasses the representation of all types of providers, including:
- Psychiatric nurses
- Psychiatric pharmacists
- Licensed professional counselors
- Clinical social workers
- Primary care physicians
- Family nurse practitioners
- Other clinicians, counselors, and therapists
Our Legal Services for Mental Health Professionals and Practices
We offer comprehensive legal advice and representation for all matters pertaining to mental health practice. Our team of professionals also includes non-lawyer consultants, auditors, and federal workers’ compensation experts who are available to provide assistance on an as-needed basis. We have extensive experience working with mental health professionals and practices with regard to licensing, compliance, transactional, litigation, and federal law enforcement matters such as:
Professional Licensing and Ethics Matters
If your professional license is at risk, or if you have been accused of violating the ethical standards you have sworn to uphold, disputing the allegations against you will be critical to protecting your practice and your reputation. We provide vigorous defense representation for all professional licensing and ethics matters, from patient disputes to state licensing board disciplinary proceedings.
DEA Registration and Controlled Substances Act (CSA) Compliance
If your mental health practice involves prescribing or administering medications, then you are subject to all relevant provisions of the Controlled Substances Act (CSA), including its registration requirements. We represent mental health providers with regard to Drug Enforcement Administration (DEA) registrations and renewals, DEA audits and investigations, and all other prescription-related compliance matters.
Medicare, Medicaid, Tricare, and DOL Billing Compliance
A significant portion of our practice is devoted to assisting mental health professionals and other heath care providers with billing and coding compliance. We assist with compliance under Medicare, Medicaid, Tricare, and all U.S. Department of Labor (DOL) programs, and we work with providers that have in-house billing programs and that outsource to third-party billing administrators. Billing and coding errors are among the most-common triggers for federal health care fraud investigations, and this means that mental health providers need to make compliance in this area a top priority.
Federal Health Care Fraud Audits and Investigations
With increasing frequency, federal authorities including the DEA, the DOL, the Centers for Medicare and Medicaid Services (CMS), the U.S. Department of Justice (DOJ), and the Office of Inspector General (OIG) are targeting mental health professionals in health care fraud audits and investigations. Mental health providers must treat audits and investigations with equal intensity, as audits have the potential to lead to follow-up investigations and the imposition of civil or criminal penalties.
Federal Civil and Criminal Defense
In addition to representing mental health providers in audits and investigations, we also provide representation for federal civil and criminal prosecutions. Our federal health care fraud defense lawyers have extensive track records in federal litigation, and we take a strategic, experience-based approach that focuses on protecting our clients as quickly, completely, and discretely as possible.
Anti-Kickback Statute and Stark Law Compliance
The Anti-Kickback Statute and the Stark Law prohibit mental health professionals and practices from entering into many types of compensation-based relationships. The Anti-Kickback Statute prohibits the payment (or receipt) of any rebates, referral fees, commissions, or other forms of “remuneration” in connection with referrals for federally-funded patients in the absence of an applicable safe harbor. The Stark Law prohibits doctors from engaging in similar types of transactions in relation to Medicare and Medicaid beneficiaries where the counterparty is an entity or individual with whom the doctor has a direct or indirect financial relationship.
Professional Malpractice Insurance Claims and Litigation
In addition to professional licensing matters and federal health care fraud defense, we also represent mental health providers in malpractice insurance claims and litigation. We work with practitioners and their insurers to assert complete defenses when possible, and to mitigate any potential liability exposure when necessary.
National Practitioner Data Bank (NPDB) Disputes
If you have had an unfavorable report filed with the National Practitioner Data Bank (NPDB), our lawyers can assist you in filing a dispute and seeking to have the report removed from your NPDB record. We assist with initial direct dispute resolution efforts as well as proceedings before NPDB Dispute Resolution Managers.
Practice Organization and Management
From choosing the most-appropriate form of legal entity (i.e. professional corporation, partnership, or limited liability company (LLC)) to preparing the necessary documentation to insulate you and your partners from personal liability, there are numerous strategic decisions that must be made with regard to organizing and managing a mental health practice. We offer full-service corporate legal services to health care providers, both for establishing new practices and for maintaining compliance and protection on an ongoing basis.
Employment Contracts and Disputes
The employment relationship presents a number of potential pitfalls for mental health professionals as well. Whether you are preparing to accept a position, preparing to terminate your employment, facing a wrongful termination, or dealing with matters as an employer, we can help you understand your legal rights and responsibilities. This includes dealing with federal employment tax matters.
HIPAA, HITECH, and Other Compliance Matters
Finally, we also assist mental health professionals and practices with regard to medical record and privacy compliance, including compliance under the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act. Our lawyers and consultants can help you implement effective privacy and confidentiality controls, and we can help you respond to allegations of recordkeeping violations, confidentiality breaches, and other complaints if necessary.
Q&A with the Federal Health Care Lawyers at Oberheiden, P.C.
Q: How important is compliance for mental health professionals in today’s legal environment?
Due to the exorbitant cost of federal health care program fraud (i.e. Medicare and Medicaid fraud), federal authorities are aggressively targeting all types of providers. Since even unintentional violations can lead to recoupments, civil fines, and other penalties, mental health professionals need to be absolutely certain that their billing and coding practices are compliant. This is true even if you rely on a third-party billing company—if your practice’s program billings are non-compliant, the federal government is going to hold your practice responsible.
Q: What are the steps involved in implementing an effective compliance program?
An effective compliance program must focus on four critical areas: (i) program documentation, (ii) program implementation, (iii) third-party contracting, and (iv) ongoing monitoring and enforcement. As a result, the first step is to determine what documentation is necessary. Once you have a comprehensive understanding of your mental health practice’s needs, then you can focus on building and implementing a program that your personnel can follow on an ongoing basis. Due to the Anti-Kickback Statute and the Stark Law, compliance must be a factor in third-party contracting as well. Finally, once everything is in place, then your efforts must shift to monitoring and enforcing compliance so that you can address any issues before the federal government comes calling.
Q: What should a mental health provider do after being contacted by federal authorities?
If CMS, the DEA, or any other federal authority is looking into your practice’s prescription or billing records, your first step should be to seek experienced federal health care defense counsel. This is not a matter that you want to try to handle on your own. Regardless of whether you can demonstrate consistent compliance or you are at risk for civil (or even criminal) penalties, you will need to work with experienced lawyers who can effectively deal with the authorities on your behalf.
Contact Oberheiden, P.C. for More Information
If you would like more information about our legal services for mental health professionals and practices, we encourage you to get in touch. To schedule a complimentary initial needs assessment with one of our experienced federal health care lawyers, call us at (214) 469-9009 or inquire online today.