Healthcare professionals operate inside one of the most heavily regulated industries in the country. Licensing rules, billing standards, HIPAA and HITECH obligations, payer contracts, employment requirements, and federal and state fraud-and-abuse statutes intersect on every patient encounter and every business decision. The firm provides legal counsel to physicians, dentists, allied health providers, medical practices, and healthcare organizations on the regulatory, transactional, and litigation issues that affect a working healthcare practice.

Call toll-free: (888) 275-2620. Available 24/7.

Who We Represent

The firm represents healthcare providers and healthcare-related businesses across New York, including:

• Physicians and physician groups
• Dentists and dental practices
• Psychologists and mental health providers
• Physical therapists and physical therapy practices
• Occupational therapists
• Medical practices and multispecialty groups
• Professional limited liability companies (PLLCs)
• Professional corporations (PCs)
• Hospitals, ambulatory centers, and healthcare organizations
• Health plans and third-party administrators, where conflicts permit

What Is Healthcare Law?

Healthcare law is the body of federal and state rules that govern how care is delivered, how providers are licensed and disciplined, how patient information is handled, how services are billed and reimbursed, and how healthcare businesses are organized. Three areas dominate most provider-side legal work.

Public health law. Statutes and regulations administered by federal agencies (HHS, CDC, FDA) and the New York State Department of Health that protect population health, govern reportable conditions, and set standards for facilities and practitioners.

Healthcare administration law. The licensing, credentialing, accreditation, recordkeeping, patient safety, and operational standards that govern medical practices and healthcare facilities. New York Education Law Article 131 (medicine), Article 133 (dentistry), Article 153 (psychology), and the regulations of the State Board for the Professions sit here.

Health insurance and reimbursement law. The rules that govern Medicare, Medicaid, commercial payers, ERISA-governed plans, prompt-pay statutes (Insurance Law § 3224-a), and the contractual and regulatory framework that determines what gets paid and when.

Healthcare Law Services

The firm’s healthcare practice covers the legal issues that recur in a working medical office. Practice formation and corporate governance: entity selection, PLLC and PC formation, operating agreements, shareholder agreements, and ownership restructuring under Education Law and Business Corporation Law Article 15. Contracting: employment agreements, independent contractor agreements, payer participation contracts, vendor and management services agreements, restrictive covenants, and buy-sell agreements. Compliance: HIPAA and HITECH policies, written information security programs, breach response, and Office for Civil Rights inquiries. Audits and investigations: Medicare and Medicaid audits, commercial payer audits, OMIG matters, and Office of Professional Medical Conduct (OPMC) and Office of Professional Discipline (OPD) proceedings. Disputes and litigation: reimbursement and recoupment claims, payer disputes, partnership and shareholder disputes, departing-physician disputes, and credentialing and peer review challenges.

Medical Practice Formation and Healthcare Business Guidance

New York imposes specific entity-formation rules on healthcare providers. Most physician practices must be formed as a PLLC or PC owned by licensed professionals; standard LLCs and corporations are not permitted to render professional medical services. The firm assists with entity selection, articles of organization, operating agreements, professional licensing coordination, EIN and Medicare/Medicaid enrollment, NPI registration, and the corporate maintenance work that protects the entity’s liability shield over time. We also advise on practice acquisitions, sales, mergers, and successor-practice transitions, including non-clinical asset structures (MSOs) where appropriate.

For tax planning that overlaps with practice structure — entity-level tax elections, reasonable compensation analysis, pass-through entity taxation, and retirement plan design for owner-physicians — see our tax law page. For broader business law support including contract review and commercial matters, see our business law services page.

Healthcare Contracting and Employment Agreements

Most disputes that reach a healthcare practice’s lawyer trace back to a contract. The firm drafts and reviews:

• Physician employment agreements (compensation formulas, productivity bonuses, call coverage, tail coverage)
• Independent contractor and locum tenens agreements
• Provider participation agreements with commercial payers
• Management services agreements (MSO arrangements)
• Vendor agreements (EHR, billing services, laboratory)
• Restrictive covenants and non-solicitation provisions
• Buy-sell, shareholder, and operating agreements
• Asset purchase and stock purchase agreements for practice transitions

HIPAA, HITECH, and Patient Privacy Compliance

Privacy policies and procedures. Drafting and updating Notices of Privacy Practices, patient authorization forms, minimum-necessary procedures, and the administrative, physical, and technical safeguards required under 45 CFR Parts 160 and 164.

Business associate agreements. Reviewing and negotiating BAAs with EHR vendors, billing companies, cloud providers, and other downstream contractors that handle protected health information.

Breach response. Investigating suspected breaches, applying the four-factor breach risk assessment, coordinating notifications to affected individuals, HHS, and the media where required, and documenting the response for OCR review.

OCR investigations. Responding to complaints, document requests, and investigations from the HHS Office for Civil Rights, including resolution agreements and corrective action plans.

Healthcare Fraud, Abuse, and Compliance Investigations

Federal and state authorities have broad enforcement tools — the federal False Claims Act (31 U.S.C. § 3729 et seq.), the Anti-Kickback Statute (42 U.S.C. § 1320a-7b), the Stark Law (42 U.S.C. § 1395nn), the New York False Claims Act (State Finance Law § 187 et seq.), and Social Services Law § 145-b. Allegations frequently arise from billing audits, disgruntled employees, or qui tam relators rather than affirmative investigations.

The firm represents providers in:

• Medicare and Medicaid audits (RAC, MAC, UPIC, OMIG)
• Commercial payer audits and recoupment demands
• Pre-payment and post-payment review
• OIG and DOJ inquiries
• OPMC and OPD professional discipline proceedings
• Self-disclosures under the OIG Self-Disclosure Protocol or the CMS Stark Self-Referral Disclosure Protocol
• Compliance program design and revision

Early counsel matters. The first letter in an audit often dictates the size and shape of the eventual exposure.

Healthcare Regulatory Compliance

Beyond fraud-and-abuse and HIPAA, healthcare practices face overlapping regulatory regimes from CMS conditions of participation, the New York State Department of Health (10 NYCRR), the Office of the Professions, the DEA for controlled-substance prescribing, and federal and state labor authorities. The firm helps practices design compliance programs proportionate to their size, address findings from regulatory surveys, and respond to professional licensing complaints before they escalate.

Health Insurance and Third-Party Payer Disputes

When a payer downcodes claims, denies medical necessity, recoups paid claims, or terminates a participation agreement, the available remedies depend on the contract, the plan type (ERISA versus fully insured versus government), and the applicable prompt-pay and external-review statutes. The firm pursues and defends payer disputes involving reimbursement methodology, downcoding and bundling, medical necessity denials, recoupment, network terminations, and out-of-network balance billing under the federal No Surprises Act and New York’s Surprise Bill Law (Financial Services Law Article 6).

Healthcare Litigation

Provider-side healthcare litigation arises from contract disputes between partners, departing-physician fights over patient lists and restrictive covenants, payer recoupment actions, employment claims, vendor disputes, and credentialing or peer review challenges. For medical-error and patient-injury matters on the patient side, see our medical litigation page. For general civil and commercial litigation across New York state and federal courts, see our New York litigation attorneys page.

Adjacent Services for Healthcare Professionals

Physicians, dentists, and practice owners typically need legal work that goes beyond the practice itself. The firm regularly handles estate planning for healthcare professionals (asset-protection trusts, professional buy-sell coordination, succession planning), tax controversy and planning, and business law matters tied to ownership of medical real estate, MSOs, or ancillary service entities.

Healthcare Law Continues to Change

The federal and state framework governing healthcare evolves continuously through CMS rulemaking, OCR guidance, OIG advisory opinions, state agency action, and case law. Practices that ran clean compliance programs three years ago can have material gaps today. Periodic legal review of contracts, privacy practices, and compliance documentation is the most cost-effective way to surface problems before a regulator or payer does.

Contact Us

Call toll-free: (888) 275-2620. Available 24/7.

The firm represents healthcare providers and healthcare-related businesses in all 62 New York counties.

Our law firm has over 3,000 client testimonials across Google, BBB, Trustpilot, and other platforms. View verified client reviews.

Contact the law firm

Last reviewed by Attorney Ronald S. Cook — May 2026

This page is for informational purposes only and does not constitute legal advice. Prior results do not guarantee a similar outcome.