Check-up: Keeping tabs on constantly evolving health care laws

By Sheila Pursglove
Legal News

Andre Perrotta’s initial introduction to the law was a jury duty summons in his early 20s.

“Contrary to most people’s experiences, I actually enjoyed being summoned,” said Perrotta, an attorney with Howard & Howard in Royal Oak and a Michigan Super Lawyers “Rising Star.”     

Perrotta said he was selectec for a criminal trial” and that experience really opened my mind to possibly exploring a career in law.

“At the same time, my sister was in law school and always spoke highly of her experiences. I later shadowed her while she was a second year law student and she ultimately convinced me to apply to law school.”   

Perrotta picked Detroit Mercy Law where he enjoyed the Law Firm Program (LFP) established during his senior year.     

“The LFP offered a unique classroom approach whereby the course was taught by a practicing attorney and the coursework involved transactions similar to those encountered by the practicing attorney-instructor,” he said. “I took several LFP courses, and they were instrumental to my law school education.”   

Winner of an internal moot court competition, Perrotta also participated in a national contest in Chicago regarding an interesting intellectually property issue.     

“I’ve always prided myself on my public speaking skills, and my experiences on moot court went a long way in honing those skills,” he said. “Moot court was also helpful because it forces participants to thoroughly analyze the legal issue from both sides in order to anticipate and rebut arguments made by the opposing side.”   

Perrotta, who focuses his practice on Health Care Regulatory Compliance and Fraud and Abuse Laws, graduated from law school in 2009, in the midst of the economic recession when many law firms were laying off attorneys and the outlook for newly minted attorneys was bleak.     

Then fate stepped in.

A few months after Perrotta became a licensed attorney, several new federal health care laws, such as the HITECH Act and the Patient Protection and Affordable Care Act were enacted, creating a greater demand for health care lawyers.    

Perrotta landed a job with ADVOCATE Radiology Billing, the nation’s largest radiology-specific medical billing company, where he spent more than three years as chief compliance officer and an in-house attorney.

He designed, implemented, and oversaw the ADVOCATE Compliance Program and reviewed and evaluated compliance issues regarding all aspects of the medical billing and reimbursement process; all while ensuring compliance with the various reimbursement laws and regulations both internally within ADVOCATE and externally on an individual client level.   

“I’m forever grateful for my time there and for the people I worked with,” he said. “The in-house experience helped me become a better attorney because I was constantly working with non-attorneys, which taught me the importance of understanding the intricacies of a business and not just the legal issues they face, and how an attorney adds value to the business.     

While the law is constantly evolving in virtually every field, this is particularly the case in health care, he noted.     

“For health care law specifically, there is a heavy focus on regulatory compliance, and I pride myself on ensuring our clients are adhering to the various regulatory requirements they face on both a federal a state level,” Perrotta said.    

“For the future, I envision an even more complex regulatory environment, especially considering the general uncertainty regarding the questions of how health care services are delivered and how providers are reimbursed for those services.”      

Some of his most rewarding work involves assisting health care providers in setting up their own practices and the various legal issues involved in that process, from negotiating a waiver of a non-compete, to forming the entity, and credentialing the new practice and providers, to contracting with third-party payors, and the myriad of the other issues the new health care practice faces.

In addition to regulatory compliance matters, Perrotta counsels clients in the area of health care fraud and abuse laws, including the False Claims Act.

Specifically, he provides the necessary Stark Law and Anti-Kickback Statute analyses for healthcare providers and suppliers, beginning with client formation (e.g. forming a solo or group practice, IDTF, joint venture) and continuing throughout the client’s routine business practices, in order to ensure compliance with these major fraud and abuse laws.

Born and raised in Cincinnati, where he earned his undergrad degree in biology from the University of Cincinnati, Perrotta now makes his home in Royal Oak with his wife, Jenna, a speech language pathologist, and their 4-year-old son and 3-year-old daughter. 

 

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