Health Care

Players in the health care field turn to Covington because they recognize that navigating government regulation is fundamental to their success. Our clients include pharmaceutical and biotech manufacturers, medical device manufacturers, health plans, providers, technology vendors and investors. We advise clients on coverage, coding and payment; compliance with fraud and abuse laws; protecting health information; accurate price reporting; and a host of other health care regulatory issues, both within the United States and globally.

Our experience includes counseling and representation in the following areas:

• Affordable Care Act
• Anti-Kickback, Stark self-referral prohibitions and related state laws
• Common rule on protections for human research subjects
• DRGs and reimbursement of hospital treatments
• eHealth, mHealth and telemedicine
• Electronic health records and meaningful use
• False Claims Act
• Graduate medical education
• Health Insurance Exchanges and Qualified Health Plans
• Health privacy and data protection, HIPAA, HITECH
• Home and community-based supports and services
• Marketing rules and restrictions
• Medicaid drug pricing and rebates
• Medicare Part D
• Out-of-network reimbursement
• Regulation of interactions with health care professionals
• Reimbursement for services, medical devices and drugs, Medicare coverage, and coding
• State Medicaid programs and State Demonstration Programs
• State licensing and scope of practice
• Sunshine Act and international transparency rules
• UK NICE Pharmaceutical Price Regulation Scheme (PPRS)
• Wellness programs
• 340B drug pricing and reporting