Clay J. Countryman
Partner - Baton Rouge
- T: 225.381.8037
- F: 225.381.8029
Clay Countryman is a partner in the Baton Rouge office of Breazeale, Sachse & Wilson, L.L.P. Mr. Countryman focuses his practice on healthcare business and regulatory matters, with a particular focus on matters related to fraud and abuse laws including the Stark Law, Federal Anti-kickback statute, and Medicare coverage and reimbursement.
Clay has served as legal counsel to several health care providers, ranging from national and regional hospital systems, physician group practices, hospitals, Louisiana Hospital Service Districts, rural hospitals and physician-owned specialty hospital, to diagnostic imaging facilities, ambulatory surgical centers, physical therapy providers, pharmacies, healthcare management companies, and healthcare trade associations.
Clay has assisted health care providers in structuring joint ventures and other transaction to promote business objectives while meeting compliance requirements of specific health care laws and regulations, such as the Stark Law, the Federal Anti-Kickback Statute, Medicare and Medicaid coverage and reimbursement requirements, licensure and accreditation requirements, and federal and state health information privacy and security requirements. Clay has also assisted providers in implementing and updating healthcare regulatory compliance programs.
Loyola University New Orleans School of Law, J.D.
University of Oklahoma, B.B.A.
American Bar Association
- Chair, 2016, ACO Task Force, ABA Health Law Section
- Chair, 2014-15, Business & Transactions Interest Group, ABA Health Law Section
- Co-Chair, 2014 and 2015, ABA Physician Legal Issues Conference, ABA Health Law Section; Chicago, IL
- Vice Chair, 2014-15, Programs Executive Leadership Committee, ABA Health Law Section
American Health Lawyers Association
Louisiana Medical Group Management Association
Louisiana Hospital Association, Society of Hospital Attorneys, Member
Health Care Compliance Association
Louisiana Ambulatory Surgery Center Association
Healthcare Information and Management Systems Society (HIMSS)
Board of Directors, St. Vincent de Paul
Baton Rouge Area Chamber Leadership Program, Class of 2015
St. Joseph’s Academy, President Dad’s Club 2014/2015
Council for a Better Louisiana (CABL) Leadership Louisiana (2016)
Honors and Awards
AV® PreeminentTM Peer Review Rated.
Ranked in Chambers USA: America's Leading Lawyers for Business for Louisiana in the area of Healthcare in 2017
- “OCR Settles First Enforcement Action for Untimely Reporting of a Breach” February 2017
- “OIG Finalizes New Anti-Kickback Statute Safe Harbors and CMP Authorities” LHA Impact Law Brief, Volume 32, No.1, January 2017
- “Final Rule Released to the OIGs Exclusion Authorities” January 2017
- “OCR Phase 2 HIPAA Audits Have Begun: Are you Ready?” September 2016
- “Anesthesia Group Settles Kickback Allegations to Obtain Exclusive Agreements With Ambulatory Surgery Centers” August 2016
- “OIG Corporate Integrity Agreements and Physician Compliance Programs” June 2016
- “'Cloning’ and 'Overpopulation’ of Documentation by Physicians in Electronic Medical Records May Lead to Allegations of Fraud” June 2016
- “Physician Practice and Hospital Pay $750,000 and $1.5 Million for Failure to Have HIPAA Business Associate Agreements” May 2016
- “OCR Settlement with Physician Group Highlights Need For HIPAA Business Associate Agreements” April 2016
- “Imported Drugs and Medical Devices: Physicians Face Significant Liability for Purchasing Imported Drugs and Medical Devices” April 2016
- “Challenges to Medicare Advantage Plans Passing Sequestration Cuts Through to Contracted Providers” April 2016
- “OCR Announces $1.55 Million Settlement Based on Failure to Have a Business Associate Agreement in Place and Conduct an Organization-Wide Risk Analysis” March 2016
- “2016 Hot Compliance Areas for Physician Practices” March 2016
- “Hot Off the Presses! CMS Issues Final Overpayment Regulations” February 2016
- “Recent False Claims Act Settlements Based on Hospital-Physician Compensation Arrangements” January 2016
- “Recent False Claims Act Settlements Based on Allegations of Improper and Excessive Hospital-Physician Compensation” December 2015
- “OIG Issues Advisory Opinion on Charitable Organization Providing Financial Support for Patients” 12/1/2015
- “CMS Issues Proposed Stark Law Changes in the Proposed 2016 Medicare Physician Fee Schedule” August 2015
- “Recent False Claims Act Case Involving Hospitalists’ Services Includes Allegations that Company’s Compliance Program and Corporate Officers Had Knowledge of Upcoding” July 2014
- “Non-Profit Health Care System Agrees to $800,000 HIPAA Settlement in Medical Records Dumping Case” June 2014
- “Federal Court Rules that Hospital Violated the Stark Law in Compensation Arrangement with Employed Physicians” LHA Impact, November 2013
- “OIG Issues Advisory Opinion 13-09 on Ownership Interests in Group Purchasing Organization By Hospital and Other Providers” August 2013
- “BSW Health Law Blog” August 2013
- “Health Care Reform Update: White House Extends Employer Coverage Mandate to 2015” July 2013
- “OIG Issues Warning to Hospitals and Other Providers In Special Fraud Alert on Physician-Owned Distributorships for Implantable Medical Devices” April 2013
- “OCR Finalizes Provisions to the HIPAA Enforcement Rule in the HIPAA Megarule To Address Liability and Civil Money Penalties for HIPAA Violations” ABA Health eSource, January 2013
- “Federal Appeals Court Overturns $45 Million Judgment Against Hospital Based On Stark Law Violations” Louisiana Hospital Association Impact Monthly Newsletter, April 2012
- “Claims Data Sharing and HIPAA Privacy Compliance: Key Components for ACOs and Other Provider Networks” Louisiana Hospital Association Impact Monthly Newsletter, February 2012
- “OIG Issues Favorable Opinion on Online Medical Information Sharing and Referral Database Service” Louisiana Hospital Association Impact Monthly Newsletter, January 2012
- “OIG Issues Favorable Advisory Opinion on Neurology Telemedicine Arrangement” Louisiana Hospital Association Impact Monthly Newsletter, September 2011
- Author of Chapter on "Entrepreneurial Medicine: Fraud and Abuse Risk Areas For Physician Business Relationships" in Physician Law, Evolving Trends and Hot Topics by ABA Publishing (2014 and 2015)
- "CMS Addresses Data Sharing and HIPAA Privacy Compliance in the Final ACO Rule", ABA Health eSource, ACO Special Edition (December 8, 2011)
- Health Care Controllers Manual, Contributing Author, Thomson Reuters Publishing (2009)
- "Managed Care Litigation Cumulative Supplement", Contributing Author, BNA (2009)
- "Managed Care Litigation Book, Prompt Pay Litigation and Related Issues and Federal Benefit Claims Procedures (affecting ERISA plans)", Contributing Author, published by BNA (September 2005)
- "HIPAA Compliance Handbook", Aspen Publishing (March 2001)
- "Physician Practice Compliance Resource Manual", Aspen Publishing (January 2001)
- HIPAA Compliance for Posting Videos to the Web, 2016 American Society for Dermatologic Surgery Annual Meeting, New Orleans, November 13, 2016
- Advanced Compliance Seminar, Louisiana Hospital Association Conference Center, September 2015
- Fraud and Abuse Traps in Physician Relationships: Lessons Learned from Recent Government Investigations, 2015 MGMA-LA Annual Conference, New Orleans, LA, August 2015
- Louisiana ASC Licensing Statutes and Regulations Resource Guide, 8th Annual Gulf States ASC Conference, LASCA Business Meeting, Biloxi, MS, June 18, 2015
- Community Clinics, Pharmacies, and Other Opportunities for Physicians and Attorneys to Work Together, ABA Physicians Legal Issues Conference, ABA Health Law Section, Chicago, IL, June 11, 2015
- HIPAA Compliance: Recent Changes to the HIPAA Rules and Enforcement Actions, Acadiana Vascular Center, Lafayette, LA, May 15, 2015
- Compliance Risk Areas: Where to Begin, Louisiana Hospital Association Basic Compliance Seminar, Baton Rouge, LA, April 29, 2015
- Government Investigations, Settlements, and Resulting Compliance Obligations of Long Term Care Providers, Co-Presenter, American Health Lawyers Association Long Term Care and the Law Conference, New Orleans, La., February 24, 2015
- Compliance Strategies for Physician Relationships, Health Ethics Trust Conference Southeast Regional, January 28, 2015
- The Evolution of a Hospital Compliance Program and the Role of the Compliance Officer, Louisiana Hospital Association 25th Annual Health Law Symposium, November 5, 2014
- Hot Fraud and Abuse Compliance Topics for Physician Practices, MGMA New Orleans 2014 Fall Workshop, September 24, 2014
- Mental Health Law Update, Louisiana Hospital Association, Baton Rouge, LA, August 20, 2014
- An Ethical Dilemma: Hospitalists and the Continuity of Care, ABA Physicians Legal Issues Conference, ABA Health Law Section, Chicago, IL, June 13, 2014
- HIPAA Compliance: Recent changes to the HIPAA Rules and Enforcement Actions, R.W. Johnson & Company/Eye Center Surgery Center; Baton Rouge, LA, May 17, 2014
- HIPAA Compliance: Recent changes to the HIPAA Rules and Enforcement Actions, Northeast La PHO; Alexandria, LA, May 13, 2014
- Why Does Security Get the Back Burner and How to Change That in Your Organization, Roundtable Discussion, HealthTech Research Advisory Council Meeting, New Orleans, Louisiana, April 2014
- HIPAA Compliance: Recent changes to the HIPAA Rules and Enforcement Actions, East Jefferson Charity Hospital Family Practice Graduate Medical Education Residents; New Orleans, LA, March 17, 2014
- 15th Annual Conference on Emerging Issues in Health Care Law, Litchfield, AZ, February 26, 2014
- HIPAA Compliance: Recent changes to the HIPAA Rules and Enforcement Actions, Ochsner Graduate Medical Education Residents; New Orleans, LA, January 27, 2014
- Legal Updates on Issues Impacting ASCs, Louisiana Ambulatory Surgery Center Association, 2014 Annual Conference, January 23, 2014
- Implementing the Omnibus Changes Part II, Including Business Associates and More, 2013 Louisiana HIPAA and E H R Conference; Baton Rouge, LA, October 28-29, 2013
- Resolving Legal and Audit Issues in an Internal Compliance Investigation, American Health Lawyers Association, and Health Care Compliance Association, Fraud & Compliance Forum; Baltimore, MD, September 29, 2013
- HIPAA Compliance and Enforcement by the Office of Civil Rights: Lessons Learned for Physician Practices, Greater New Orleans Medical Group Management Association; New Orleans, LA, September 26, 2013
- HIPAA Compliance Made Easy for Physician Practices, Louisiana Medical Group Management Association 2013 Annual Conference; New Orleans, LA, August 21, 2013
- Compliance Topics for ASCs, 2013 Gulf States ASC Conference; New Orleans, LA, June 19, 2013
- Current Fraud and Abuse Initiatives Impacting Physicians, 2013 Physician Legal Issues Conference, American Bar Association Health Law Section; Chicago, IL, June 13-15, 2013
- Mental Health Law Update, Louisiana Hospital Association; Baton Rouge, LA, May 9, 2013
- Implementation - Business Associates and Breach Notification, HIPAA Changes - Understanding and Implementing the Latest Rule, 2013 Louisiana HIPAA & EHR Conference; Baton Rouge, LA, March 11, 2013
- HIPAA Compliance: Recent Enforcement Actions and Recent Changes to the HIPAA Rules, Louisiana Orthopedic Association Annual Meeting; New Orleans, LA, March 2, 2013
- HIPAA Enforcement by the Office for Civil Rights: Lessons Learned for ASCs, Louisiana Ambulatory Surgery Association Conference, January 24, 2013
- Hospital-Physician Alignment Strategies, Louisiana Hospital Association Conference; Baton Rouge, LA, January 24, 2013
- Advanced Business Associate Issues, Louisiana HIPAA & EHR Conference; Baton Rouge, LA, September 29, 2012
- New Healthcare Delivery Models: Challenges for Physician Practices, Greater New Orleans Medical Group Management Association Compliance Boot Camp; New Orleans, LA, September 26, 2012
- Hot Compliance Topics for Physician Practices: 2011 Year in Review, Louisiana Medical Group Management Association 2012 Annual Conference; Lake Charles, LA, April 21, 2012
- Fraud and Abuse Compliance in Mental Health Settings, Louisiana Hospital Association/Mental Health Law Update, March 1, 2012
- Federal and State Legal Issues Impacting Ambulatory Surgery Centers, Louisiana Ambulatory Surgery Association 2012 Annual Meeting, January 25, 2012
- Hospital-Physician Alignment Strategies, Louisiana Hospital Association 22nd Annual Fall Health Law Symposium; Baton Rouge, LA, November 2, 2011
- Challenges for Physician Practices Since Healthcare Reform in 2010 and Alignment Strategies for Physicians and Hospitals After Healthcare Reform, Greater New Orleans Medical Group Management Association, September 15, 2011
- Managed Care Contracting, Baton Rouge Medical Group Management Association, August 11, 2011
- 2010 Fraud and Abuse Enforcement Year in Review, Louisiana Society of Hospital Attorneys 21st Annual Health Law Symposium, November 4, 2010
- Navigating Fraud and Abuse Issues with Health Care Reform and Other ASC Business Relationships!, 2010 Gulf States ASC Conference; Biloxi, Mississippi, June 15, 2010
- Represented physician groups in the acquisition of the group and subsequent employment by a hospital or health system.
- Represented healthcare providers in internal compliance investigations and resolving overpayment and related issues under the Federal False Claims Act.
- Advised several health care provider clients on compliance with the Stark Law, Federal Anti-Kickback Statute and other similar laws applicable to their business operations.
- Advised physician groups and other health care providers in the formation of joint ventures to own and operate diagnostic imaging centers, hospitals, ambulatory surgical centers and cancer treatment centers.
- Drafted and reviewed several types of agreements for healthcare providers, including professional service agreements, employment agreements, physician recruitment agreements, medical director agreements, third-party billing agreements, management agreements, and HIPAA policies and procedures.
- Advised health care providers regarding managed care contracting and network provider agreements with commercial insurance carriers and other third-party payers.
- Advised physician groups, hospitals and other health care providers to create and implement forms, policies and procedures to comply with the HIPAA Privacy and Security Rules.
- Formed limited liability companies and other corporate entities on behalf of health care providers, including drafting and reviewing operating agreements and corporate by-laws.
- Advised several types of health care providers to develop and implement a compliance program.
- Advised several hospital-based physician groups, including anesthesiologists, radiologists and pathologists, regarding exclusive agreements with Hospitals.