The delivery of quality health care requires doctors to be on the cutting edge of clinical developments, research, and technology relevant to their field of medicine. The management of a medical or dental practice requires an increasing awareness of a host of legal and compliance issues that are beyond the ability of doctors to fully comprehend and be prepared for.
Every medical and dental practice is involved in contractual arrangements such as managed care contracts, leases, employment contracts, buy/sell arrangements, billing, and vendor service agreements. In addition to these, there is a host of compliance issues including federal and state laws such as anti-kickback, fraud and abuse, Stark, HIPAA, OSHA, employment, and consumer protection, to name a few.
Accountants and consultants specializing in health care can be of assistance in reviewing, structuring, and advising on the financial and operational aspects of contractual arrangements and compliance. However, they are not qualified and, in some cases, are prohibited by their profession to render legal advice. Doctors should not ask accountants or consultants (or other doctors) for legal advice. They may help identify legal issues, but they should refer the doctor to an attorney for legal advice.
Doctors complain that legal fees are expensive — so what isn’t? There are two adages that are very true and relevant here. First “an ounce of prevention is worth a pound of cure,” and, second, “pay me now, or pay much more later.”
Unfortunately, many doctors seek legal advice too late to avoid losses, and the attorneys end up in a costly damage-control engagement. Legal fees are a cost of doing business, as are other professional fees. There is an intangible value to receiving sound legal advice that is difficult to measure. Doctors will never know how much they saved in litigation and settlement costs by retaining competent legal counsel.
However, practices that have a long standing record of growth, financial success, and group harmony are usually those that engage their legal counsel, along with their accountant and consultant, as an active member of the management advisory team. Practices that fail or continually face expensive litigation costs and discord among their members can often be found to have shortchanged themselves on legal advice. Often, a loss or contested issue can be traced to something as simple as an omission in a contract that was never reviewed by legal counsel.
Engaging an attorney experienced in health care law is as important as seeing a cardiologist for a heart condition. Attornies experienced with medical practices bring added value to the table that is worth the increased hourly rate. Some practices retain a generalist as their legal counsel and call upon a specialist when needed. “When needed” often ends up being “too late.”
Accountants and consultants who specialize in health care readily recognize the value of legal counsel who are also experienced in this field and can assist you in engaging an attorney.
James B. Calnan, CPA, is partner-in-charge of the Health Care Services Division of Meyers Brothers, P.C. in Longmeadow; (413) 567-6101.