Telemedicine business models may prompt regulatory scrutiny, including board investigations. In this case, HLA's experienced defense attorneys successfully resolved a three-year, multi-state investigation with no licensing or other implications.

Our client, a Doctor of Dental Surgery, was the subject of a multi-state investigation that spanned nearly three years. The time and operational drag on the business arising from these investigations was significant, but the Prosecution Division of the Pennsylvania Department of State's Office of Chief Counsel recently closed their file on this matter with no further action or licensing implications.

PBM audit

Telemedicine is an Enforcement Risk Factor

Using our background as former prosecutors, federal investigators, and government regulators, HLA advises a wide spectrum of clients across the healthcare delivery chain on how to take risk in a safe and compliant manner.

Although there a number of factors that potentially increase risk in the highly regulated healthcare industry, the Department of Justice and supporting agencies, such as HHS-OIG and the FBI, have prioritized civil and criminal investigations relating to telemedicine in recent years.

Telemedicine is often the subject of federal focus because it typically crosses state lines and involves relatively high claim volume.

HLA's Defense Strategy

In this case, we helped the investigative agencies to understand the telemedicine space in great detail, which provided context for our arguments that the client's business model was fully compliant with all applicable laws and regulations.

In the healthcare industry, there is a lot of "grey," which provides for innovation and business opportunities. At the same time, if you or your business are seeking to capitalize on those opportunities, it is critical to have a compelling narrative that will address any regulatory concerns in the event of scrutiny. Reliance on experienced defense counsel often helps to support that narrative.

State Officials Declined to Prosecute

Based on our factual and legal arguments, multiple state licensing boards, including the Pennsylvania Department most recently, declined to take further action and closed their file. Now our satisfied client can refocus his energy where it should be, on running his business.

Frequently Asked Questions

Common PBM Audit Triggers and How to Avoid Them

Guide independent pharmacies in recognizing and proactively managing specific behaviors and operational trends that commonly lead to PBM audits. This article will offer a detailed watchlist of PBM audit triggers and present practical, actionable steps for minimizing risks of audit findings and compliance issues.

Read More >>

Navigating Informed Consent Requirements in Telehealth: A Provider’s Guide

We examine the complex requirements and risks associated with informed consent for telehealth providers. The article provides actionable advice on navigating the regulatory landscape and practical steps to ensure legal compliance and patient safety.

Read More >>

Department of Justice Declines to Prosecute HLA Client for Alleged $6M Fraud

After the Department of Justice threatened to indict our client for involvement in an alleged $6M healthcare fraud, we stood firm and our tenacious advocacy ultimately convinced the Strike Force to decline prosecution, representing a complete win for HLA's client.

Read More >>

Triumph Over Optum: HLA’s Tenacious Advocacy Reverses Optum’s Termination of a Texas Pharmacy

Health Law Alliance successfully reversed Optum’s termination of a Texas pharmacy from its network, protecting the pharmacy from severe financial and reputational damage. Our healthcare attorneys used strategic legal expertise and negotiations to overturn the decision, ensuring the pharmacy could continue serving patients. This victory highlights our dedication to strong advocacy and proven results.

Read More >>