Healthcare & Regulatory Law

If you are looking to contact a lawyer in Great Neck or New York City, please feel free to contact the Raymond Iryami Law Firm in any number of ways. In addition to the addresses, phone and fax numbers below, please feel free to contact the Raymond Iryami Law Firm by email at info@raymondiryami.com or by Instant Message, screenname: raymondiryami (AOL/AIM/Gmail). Whatever way you choose, we look forward to serving you.

Raymond Iryami Law Firm P.C.
305 Madison Avenue, 46th Floor
New York, NY 10165
Telephone: 212-599-1081
Fax: 212-697-0877

or


Raymond Iryami Law Firm P.C.
1010 Northern Boulevard, Suite 208
Great Neck, New York 11021
Telephone: 516-336-2586
Fax: 516-706-1540

As described by the New York State Department of Health, Certificate of Need (CON) is the process that governs the establishment and construction of health care facilities in New York State.

Certificate of Need Applications (CONs) are required for all health care facilities, such as nursing homes and diagnostic and treatment centers (DNTs) that propose construction, acquisition of major medical equipment, changes in ownership and the addition of services.

A successful CON must typically demonstrate at least four elements:

1. Need: the need for the facility in the location proposed by the applicant.
2. Character: the fitness of the applicant to operate the proposed healthcare facility.
3. Competence: the competence of the applicant to operate the healthcare facility.
4. Feasibility. the financial feasibility of the proposed healthcare facility to generate revenues projected by the applicant.

The CON Application process involves compliance with various statutes set forth in the New York Public Health Law, and regulations promulgated by the New York State Department of Health. These statutes and regulations also describe the role of the Public Health Council and the State Hospital Review and Planning Council (SHRPC) with respect to certain applications submitted to the New York State Department of Health.

If you have any questions about the Certificate of Need Application (CON), please feel free to contact the Raymond Iryami Law Firm at 212-599-1081.

The Centers for Medicare & Medicaid Services (CMS) has just proposed new tougher regulations under the Stark Law (Self-Referral Law). The new regulations modify a number of physician self-referral provisions with the intent "to close loopholes that have made the Medicare program vulnerable to abuse."

The proposed regulations bear close scrutiny by physicians, as the proposed regulations may make it harder for physicians to comply with the federal Stark Law (Self-Referral Law). If you have any questions regarding the Stark Law, the new proposed regulations, or would like to receive a copy of the proposed regulations, please feel free to contact the Raymond Iryami Law Firm.

The proposed regulations are expected to be finalized in the fall, after public comments have been received. The deadline for submitting comments is August 31, 2007. Once finalized, the new regulations would take effect January 1, 2008.
 

I am often asked to explain what Health Law--also known as Healthcare Law--means. Health Law can encompass a wide variety of matters, but as it relates to our practice, Health Law involves representing healthcare providers in their business transactions, commercial litigation, or regulatory matters.

Still confused? Think of it this way. Healthcare providers--whether a doctor or a hospital--have all the typical legal needs of any business. They have to have a lease with their landlord or an employment agreement with their staff. But healthcare providers are subject to certain federal and state laws and regulations that apply only to healthcare providers. Even a sublease agreement between two doctors, if not done right, can result in a criminal violation.

With our knowledge of healthcare law, we can help healthcare providers comply with the myriad of regulations that apply to them.

I just found out some terrible news. Professor Abraham Abramovsky has passed away. He was 60, according to an email from Dean Treanor of Fordham University School of Law, where Professor Abramovsky taught.

I had just had lunch with Professor Abramovsky a couple of months ago where we discussed some projects. We were going to hold a seminar for doctors and other healthcare professionals on complying with STARK and the Anti-Kickback laws that apply to healthcare professionals.

It is such a shame to have lost Professor Abramovsky. He was more than my teacher. He gave me my first job in the legal profession; he hired me as assistant to help draft his regular column in the New York Law Journal. When it came time to applying to the big law firms that recruited us at Fordham, Professor Abramovsky gave me the most memorable advice: "Lifestyle matters." His point about the burden of big-firm life on a lawyer's family and friends was well-taken.

Professor Abramovsky was nothing but supportive when I told him about having my own law firm. That's when he suggested we hold that seminar together. I was going to cover the corporate and regulatory aspects of the healthcare laws, and he would cover the criminal aspects. And Professor Abramovsky knew fully well that healthcare professionals do have to worry about criminal laws in their practice.

In the end, Professor Abramovsky was, first and foremost, a father. And he never beamed more than when he would talk about his children. He was naturally proud to talk about how they have followed their father's footsteps. They will surely miss their father. I will surely miss my mentor.

The New York State Office of Alcoholism and Substance Abuse Services today proposed new regulations that, if ultimately promulgated, would require participating programs to ban smoking in their programs. Currently, these programs only focus on treatment for alcohol or substance abuse.

In proposing the new regulations, OASAS took the position that the programs' current focus on alcohol or substance abuse addiction would not be hampered by the new mandates to ban tobacco use. OASAS will now accept comments from the programs and the public before adopting the regulations.

The proposed regulations would be yet another layer of mandates on the programs with respect to smoking. Both New York State and New York City currently have in place laws that banned smoking in restaurants and other public places. The authorities had previously taken the position that these laws applied to substance and alcohol treatment programs, though I had successfully argued on behalf of a client that these programs should be exempt from general anti-smoking regulations.

The full-text of the proposed regulations can be found at:

http://www.oasas.state.ny.us/tobacco/providers/reg856.cfm

If you have any questions regarding the proposed regulations, please feel free to contact us.

It is not unusual for doctors--or perhaps, anyone--to feel a bit apprehensive about lawyers. But a recent article in a business publication discusses how sometimes a lawyer can be a doctor's best friend.

Yes, some lawyers bring medical malpractice cases against doctors on behalf of their patients. No, most doctors don't care much for those lawyers. As the article published in the Las Vegas Business Press points out, however, there exist other lawyers who help doctors safely navigate "a virtual minefield of state and federal regulations." There are various names for this field of law. Health Law is one. I prefer Healthcare Law.

Healthcare Law (or Health Law, if you prefer) appears to be little understood, as evidenced by the number of questions we receive about this practice area. Healthcare providers--be it, hospitals, nursing homes, or doctor's offices--have all the usual legal needs of any business. They have to have a lease with their landlord. They need employment agreements for their employees. And, they get sued by their vendors, as any business might. Healthcare being a heavily regulated industry, however, healthcare professionals must also comply with a myriad of federal and state regulations. Federal and state self-referral laws (STARK Law). Federal and state anti-kickback law. State professional licensing rules. State public health law. State privacy laws. And, oh yes, HIPAA.

All of these laws and regulations are part of that minefield that the article discusses.

Fortunately, there is some good news. As alluded to in the article, healthcare lawyers are there to walk doctors and other healthcare professionals through the minefield. And there are indeed safe passages through the minefield. Successful passage depends on the doctor and the healthcare lawyer working together. Doctors who fail to reach out to such lawyers, the article says, do so at their own peril.

So I was asked the other night by someone I met at a function if a particular lawyer was the "best lawyer in New York"? Best lawyer in New York? Hmmm.

The question was quite natural. We all want to use the "best lawyer" we can find. And for the money that lawyers often charge, we figure, he or she better be the best! Still, the notion of the 'best lawyer in New York' is a bit more complicated.

Ultimately, you want to choose the best lawyer in New York--for you and your particular matter.

To begin with, you need to make sure that the attorney of your choice handles the kind of matter you need. Your podiatrist brother-in-law may indeed be among the best in his profession, but he would be the first to refer you to a cardiologist if you are complaining of chest pains. To a certain extent, similar concepts apply in choosing a lawyer. I, for example, have never handled a divorce case in my years of legal practice and would be the first to refer such cases to those who do handle them.

That is not to say you need New York's most specialized lawyer in every matter. If you are looking to start your own small business, you don't necessarily need to hire a lawyer who has been hired by Microsoft. Sure, you do need a lawyer who is familiar with New York corporate law, but you are probably wasting your money if you are hiring for your start-up venture a law firm that primarily handles Fortune 500 companies.

In the end, the choice of the best lawyer for you may come down to comfort level and trust. You need to make sure that you can trust your own lawyer. How can you tell? Asking trusted friends is one way. Having a conversation with the lawyer can sometimes give you some clues. And, sometimes you have a third way.

That third way is to see if others have trusted him. Lawyers often list their affiliations with various professional or charitable organizations on their web sites. See if the lawyer has been entrusted with positions of trust and leadership in such organizations. No, it's not a guarantee. But using a lawyer who has been entrusted by a number of organizations and associations may be worthy of your trust as well.

Or maybe not. As I said before, the matter of the "best lawyer" is really a matter of the best lawyer--for you.

In case you missed it, we wanted to share an article that first appeared in the New York Times last week about the troubles that HIPAA has continued to pose for healthcare providers. The article points out how HIPAA, a complex federal privacy statute, has been misunderstood. Even those who wrote the law are unhappy with the results:

"Senator Edward M. Kennedy, Democrat of Massachusetts, a sponsor of the original insurance portability law, was dismayed by the “bizarre hodgepodge” of regulations layered onto it, several staff members said, and by the department’s failure to provide “adequate guidance on what is and is not barred by the law.” Further legislative measures are reported to being considered.

Of course, help cannot come soon enough for those healthcare providers who are trying their best to help comply with HIPAA. The only solace for them is that, with the proper legal guidance, hospitals, nursing homes, doctors, and others healthcare professionals can navigate the confusing and hard-to-understand provisions of HIPAA.

The New York Times article can be found here:

www.nytimes.com (registration may be required).

Or here:

http://www.tuscaloosanews.com/

New York Attorney General Andrew Cuomo has issued subpoenas to more than 50 home care agencies as part of his investigation into fraud and abuse in the health care industry.

This news has been splashed on the pages of the major newspapers in New York City and Long Island today, from the New York Post to the New York Times.

The agencies targeted in this investigation will now have to deal with the considerable headache of producing documents to the Attorney General and figuring out as best they can, with the advice of their counsel, if they face any potential legal liability.

But the news also serves as a warning to other healthcare providers. If you bill Medicaid, Medicare and/or are subject to regulation by the New York State Department of Health or other regulatory agency, government authorities, including the New York Attorney General, are increasing scrutinizing your operations to make sure you are complying with the myriad of state and federal statutes and regulations that apply to you.

If you have any questions on whether your entity is in compliance with the pertinent statutes and regulations, please feel free to contact us.

Welcome to the Raymond Iryami Law Firm P.C. Blog! Here, we hope to share with you news, information, and perspective relevant to our practice areas and community. We hope you will find such information helpful. Naturally, we are also here to answer your questions. Please feel free to email me at raymond@raymondiryami.com.