Civil Rights for Institutionalized Persons Act
Since Congress enacted Civil Rights for Institutionalized People Act (CRIPA) (link), many states have been investigated and sued by the United States Department of Justice in relation to conditions of confinement in facilities for individuals suffering from mental illness or developmental disabilities. Our firm vigorously and successfully defends state governments in litigation against the United States Department of Justice in these suits. (link) Many times, we have assisted state agencies in developing workable settlements with the Department of Justice in order to ensure fair and amenable solutions to lengthy CRIPA investigations and resulting litigation. Our expertise in this area has benefited many state agencies in difficult legal matters and complex litigation. States often benefit from our specialized knowledge of CRIPA and the rights of the states when dealing with this type of investigation.
Americans with Disabilities Act
Our firm also assists state government in relation to Americans with Disabilities Act, (ADA) (link) lawsuits brought by private plaintiffs, often as a class or by the United States Department of Justice. The Supreme Court’s decision in Olmstead v. LC (link) affected how the United States views institutionalized individuals and their right to live in the environment of their choice. States are charged with developing opportunities for individuals with disabilities through accessible systems of cost-effective community based services. The Olmstead decision interpreted Title II of the ADA and its implementing regulation, requiring states to administer their services, programs, and activities "in the most integrated setting appropriate to the needs of qualified individuals with disabilities." This decision has been interpreted many times by District and Circuit Courts around the country. In addition to defending a state in litigation, we also assist states with Olmstead planning by providing a wide range of services including lectures and presentations, training sessions with state agency employees and discussion forums. Our firm takes a proactive approach to assist states in complying with the ADA and develop programs which help state agencies to comply with the ADA and the Supreme Court’s decision in Olmstead v. L.C.
Individuals with Disabilities Education Act
States may also face opposition relating to their compliance with the Individuals with Disabilities Education Act (IDEA). (link) Our firm represents state agencies to resolve litigation or ensuing litigation against the state regarding their implementation of the IDEA. We also offer consulting services to state agencies and facilities to ensure compliance with the IDEA and assist with the state’s objective of providing a Free and Appropriate Public Education to its disabled children.
CMS Appeals
Fraud & Abuse Litigation
Physicians, hospitals, managed care organizations and many other providers of health services face significant regulatory hurdles as payors attempt to combat health care fraud and abuse. In addition, the efforts by payors to reduce or at least contain costs have challenged health care providers to develop new professional relationships and organizational structures. However, many of these new relationships and structures must be reviewed carefully to ensure that a wide array of federal and state laws governing fraud and abuse are not violated.
York Legal Group has counseled health care organizations throughout the country in managing the risks of fraud and abuse. The rules governing fraud and abuse continue to evolve as new laws are passed, new regulations are promulgated, new cases are tested in the courts, and new government settlements take place.
York Legal Group provides complete legal support for health care organizations in connection with fraud and abuse compliance, state and federal anti-kickback, self-referral, false claims and secondary payor issues.
Stark/Self-Referral
In 1980, the US Congress adopted the first self-referral provision by limiting the ability of a physician to certify a plan of care for a patient to receive services from a home health agency in/with which the physician had a significant ownership interest or financial/contractual relationship. Over the years, this concept has significantly expanded as additional provisions have been adopted by the Federal government by limiting the ability of physicians to refer patients to a health care entity for the provision of certain services if the physician (or an immediate family member of the physician) has either an ownership interest in or a compensation arrangement with such health care entity. This Federal law is commonly referred to as the "Stark Law" or the "Physician Self-Referral Law." Physician financial relationships also have attracted the attention of state legislators and regulators as numerous states have adopted similar laws and regulations.
The rules governing the Stark Law continue to evolve as new regulations are promulgated, new cases are tested in the courts, and new government settlements take place. All of these activities require ongoing reviews of new and existing contractual and financial relationships among health care entities and physicians. York Legal Group has extensive experience counseling clients with regard to the application of the Stark Law and similar state laws to a myriad of transactions and financial relationships encountered in today's health care industry.
Our attorneys are familiar with and provide legal counsel to clients on, the Stark Law’s application to: ownership in hospitals, support agreements among components of an academic medical center, ancillary services being furnished by a physician’s office, the array of compensation arrangements that physicians commonly enter into, the sale of a physician practice, ownership in rural entities, as well as the law’s application to managed care arrangements.
CMS Appeals
The York Legal Group, LLC provides counseling and litigation services involving regulatory dealings with CMS, whether at the licensing stage, operating guidelines, survey procedures, communications with CMS, processing of appeals, or litigation concerning CMS funding.
The attorneys at the York Legal Group, LLC have decades of combined experience in counseling clients dealing with CMS surveys and CMS funding issues and appeals.
Because this is a new area of regulatory involvement, and, due to the changing demographics of the United States population, the area of CMS Compliance is rapidly changing and expanding. Because the penalties for noncompliance are so severe, we counsel our clients to make every effort to stay up to date with the latest developments in CMS regulations.
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