If you’re running a medical practice, hospital, or any healthcare facility in Texas, you’ve probably felt the weight of constantly changing regulations. One day you’re focused on patient care, and the next you’re trying to decipher new compliance requirements that seem to multiply faster than you can keep up with them.
I’m Elissa Brewster Langston, a lawyer at Brewster Law Firm, and I work with healthcare providers right here in Sugar Land and across Texas who are trying to build successful practices while staying on the right side of the law. Let me walk you through what healthcare consulting really means in our state and how it can protect your practice.
What You Need to Know Right Now
- Texas requires specific licenses for healthcare facilities under the Texas Health and Safety Code, and operating without proper licensing can shut down your practice and result in significant penalties.
- Healthcare consulting goes beyond basic compliance advice. It includes everything from facility licensing and credentialing to employment law, contract negotiations, and defending against regulatory investigations.
- The Texas Medical Board, Texas Health and Human Services Commission, and federal agencies like CMS all have jurisdiction over different aspects of your practice, which means you’re answering to multiple regulatory bodies simultaneously.
- The Texas Health and Human Services Commission (HHSC) is the state agency that licenses and surveys many types of health facilities and handles complaints and enforcement for facility licensing.
- Mistakes in healthcare consulting can be costly. Improper billing practices, inadequate privacy protections, or non-compliant employment agreements can lead to civil penalties, criminal charges, or exclusion from federal healthcare programs.
- Working with a healthcare attorney who knows Texas law specifically can help you avoid problems before they start, rather than scrambling to fix them after an investigation begins.
Let’s Talk About Why This Actually Matters for Your Practice
You didn’t go to medical school or nursing school to become a legal authority. You went because you wanted to help people get better. But here’s the reality in Texas. The moment you open your doors to patients, you’re also opening yourself up to a web of state and federal regulations that can feel overwhelming.
Healthcare consulting in Texas means getting practical, actionable advice on how to run your practice legally and successfully. It’s not about creating a business plan or marketing strategy. It’s about making sure your practice structure, employment relationships, billing procedures, and patient care protocols meet the requirements set out in Texas law.
When I sit down with a new client, they often tell me they’ve been operating based on what they heard from a colleague or what they read online. That approach works until it doesn’t. And when it doesn’t work, the consequences can include loss of licensure, exclusion from Medicare and Medicaid, civil monetary penalties, or even criminal prosecution.
Let me be clear about something. Texas has its own set of rules that apply to healthcare providers, separate from federal requirements. You need to comply with both. The Texas Health and Safety Code, Texas Occupations Code, and various administrative rules from state agencies create a regulatory structure that’s specific to our state. What works in California or Florida might not work here.
What Does Healthcare Consulting Really Cover Anyway?
When people hear “healthcare consulting,” they sometimes think it just means help with compliance checklists. But the scope is much broader than that.
Facility Licensing and Regulatory Compliance
Under Texas Health and Safety Code Chapter 241, hospitals must obtain and maintain licenses to operate legally in Texas. Similar requirements exist for other facility types, including ambulatory surgical centers, birthing centers, nursing facilities, and assisted living facilities under various chapters of the Health and Safety Code.
Getting your initial license is just the beginning. You need to maintain compliance with ongoing requirements, prepare for surveys and inspections, and respond appropriately when deficiencies are cited. I help clients through this process, from initial applications through renewal and response to regulatory actions.
Professional Licensing and Credentialing
Your facility license is separate from the individual licenses held by your physicians, nurses, and other healthcare professionals. The Texas Medical Board regulates physicians under the Texas Occupations Code, Title 3. The Texas Board of Nursing regulates nurses. Other boards regulate various healthcare professionals.
If you’re hiring physicians, advanced practice nurses, physician assistants, or other licensed professionals, you need to verify their credentials carefully. You also need employment or contractor agreements that comply with Texas law. Texas law restricts non-physicians from controlling the practice of medicine, so your entity must be structured properly (such as a PA, PLLC, or management services organization) to avoid problems with the corporate practice of medicine and fee-splitting rules.
Corporate Structure and Business Formation
How you structure your healthcare business matters under Texas law. The corporate practice of medicine doctrine, which exists in Texas, generally prohibits corporations from practicing medicine. There are exceptions and workarounds, but you need to structure your entity correctly from the start.
Whether you’re setting up a professional association, a professional limited liability company, a management services organization, or another structure, each option has different legal implications. I work with healthcare providers to choose and establish the right structure for their specific situation.
Employment Law and Human Resources
Healthcare facilities are employers, which means you’re subject to both federal and Texas employment laws. You need compliant employee handbooks, proper classification of workers as employees versus independent contractors, appropriate wage and hour practices, and policies that comply with healthcare-specific requirements.
Texas is an at-will employment state, but that doesn’t mean you can terminate employees for any reason. There are numerous exceptions and protections. You also need to handle employee health information properly, both under HIPAA and the Texas Medical Records Privacy Act (Texas Health & Safety Code, Chapter 181), which works together with HIPAA and in some areas provides additional protections.
If You’re Asking This Question, The Answer Is Probably “Yes”
Let me ask you some questions. Have you reviewed your employment agreements in the last year to make sure they comply with current Texas law? Do you have written policies and procedures that meet state and federal requirements? Have you trained your staff on HIPAA and other privacy requirements? Do you know whether your billing practices comply with Medicare and Medicaid rules?
If you hesitated on any of those questions, you could benefit from healthcare consulting. Here are some specific situations that often prompt healthcare providers to reach out to me.
You’re starting a new practice. Getting things right from the beginning is much easier and less expensive than fixing problems later. I help new practices with entity formation, licensing applications, employment agreements, compliance programs, and all the foundational work needed to operate legally.
You’re hiring new providers or staff. Each time you bring on a new physician, nurse practitioner, or other licensed professional, you need proper credentialing, an appropriate employment or contractor agreement, and clear policies about their scope of practice and responsibilities.
You received a notice from a regulatory agency. If you get a letter from Texas Health and Human Services, the Texas Medical Board, Medicare, or any other regulatory body, don’t wait to get legal help. The time to respond is usually short, and how you respond matters.
Your practice is growing or changing. Expansion brings new legal issues. Opening a second location, adding new service lines, acquiring another practice, or restructuring ownership all require legal review to ensure compliance.
What Keeps Healthcare Providers Up at Night (Legally Speaking)
The healthcare legal environment changes constantly, but some issues consistently create problems for Texas providers.
Federal Fraud and Abuse Laws
The Anti-Kickback Statute and the Stark Law are federal laws that prohibit certain financial relationships between healthcare providers. These laws apply to any provider who participates in federal healthcare programs like Medicare and Medicaid. Violations can result in civil monetary penalties, exclusion from federal programs, and criminal prosecution.
Texas providers need to be particularly careful about arrangements with physicians, including medical director agreements, call coverage payments, space and equipment leases, and other financial relationships. These arrangements often need to fit within a specific exception or safe harbor to be permissible.
Privacy and Data Security
HIPAA requires healthcare providers to protect patient health information. But Texas also has its own medical privacy laws, including the Texas Medical Records Privacy Act found in the Texas Health and Safety Code. Texas law sometimes provides more protection than federal law.
You need written policies, staff training, business associate agreements with vendors, and incident response procedures. A data breach can result in notification obligations, regulatory investigations, and civil penalties.
Billing and Reimbursement Compliance
Medicare and Medicaid have detailed rules about what services can be billed, how they must be documented, and what codes should be used. The False Claims Act allows the government to pursue providers who submit improper claims, and penalties can be severe.
I work with clients on billing compliance, including chart documentation, coding accuracy, and proper submission of claims. It’s not enough to hire a billing company and assume they’re doing everything correctly. You’re ultimately responsible for the accuracy of claims submitted under your provider number.
Why Healthcare Consulting Isn’t Just “Regular” Business Advice
Healthcare is heavily regulated in ways that other industries are not. When I work with a healthcare client, I’m not just thinking about general business law. I’m thinking about medical board regulations, facility licensing requirements, Medicare conditions of participation, HIPAA privacy rules, fraud and abuse laws, and numerous other healthcare-specific requirements.
A general business lawyer might help you form an LLC or draft an employment agreement. But they might not know that certain business structures are prohibited for medical practices under the corporate practice of medicine doctrine. They might not realize that your employment agreement with a physician needs specific provisions to comply with the Stark Law.
Healthcare consulting also requires knowing how different regulatory bodies interact. Your practice might be subject to oversight from the Texas Health and Human Services Commission, the Texas Medical Board, the Centers for Medicare and Medicaid Services, the Department of Health and Human Services Office of Inspector General, and potentially other agencies. Each has different rules and different enforcement authority.
What Should You Look for in a Healthcare Attorney?
If you’re looking for someone to help with healthcare legal issues in Texas, here’s what I recommend you consider.
First, make sure they actually practice healthcare law. Healthcare law is a distinct area, and it requires specific knowledge and experience. Ask about their background, what percentage of their practice is healthcare, and what types of healthcare clients they represent.
Second, make sure they know Texas law specifically. Healthcare law varies significantly from state to state. Federal law creates a baseline, but each state adds its own requirements. You need someone who knows the Texas Health and Safety Code, Texas Occupations Code, and Texas administrative rules, not someone who practices primarily in another state.
Third, look for someone who can explain things clearly. Healthcare law is complex, but that doesn’t mean explanations need to be incomprehensible. I try to explain legal issues to my clients in plain language they can apply to their practices.
Non-Compliance Consequences No One Wants to Face
Ignoring compliance requirements doesn’t make them go away. It just increases the likelihood that you’ll face enforcement action when a problem comes to light.
Here are some real consequences that Texas healthcare providers face for non-compliance. License suspension or revocation from state licensing boards. Exclusion from Medicare, Medicaid, and other federal healthcare programs. Civil monetary penalties that can reach hundreds of thousands or even millions of dollars. Criminal prosecution for fraud or other violations. Loss of hospital privileges or participation in health insurance networks. Damage to professional reputation that can be difficult or impossible to repair.
I’ve worked with clients facing each of these consequences. In many cases, the problems could have been avoided with proactive compliance efforts. Once you’re facing an enforcement action, your options are more limited and the potential penalties are already on the table.
Is Hiring a Healthcare Lawyer Worth the Price Tag?
Cost is often a concern for healthcare providers, particularly those in small practices with limited resources. I get that. Healthcare is a business, and you need to manage costs carefully.
Most healthcare attorneys charge on an hourly basis for consulting work. Rates vary depending on the attorney’s experience, geographic location, and the complexity of the matter. Some matters, like contract review or entity formation, might be handled on a flat fee basis.
Here’s my perspective on cost. Yes, legal services cost money. But the cost of fixing legal problems is almost always higher than the cost of preventing them. A few hours of legal time to review an employment agreement before you sign it is much less expensive than litigating a dispute over that agreement later.
Similarly, spending time and money on compliance programs and policies can prevent regulatory investigations and enforcement actions that would be far more costly to defend.
Here’s the Bottom Line for Texas Healthcare Providers
- Texas healthcare consulting goes beyond business advice. It requires knowledge of state and federal laws. Attorneys familiar with Texas Health and Safety Code, Texas Occupations Code, and administrative rules can help providers avoid costly mistakes and meet Texas-specific requirements.
- Legal help is often needed for facility licensing, professional credentialing, corporate structure, employment matters, contracts, billing compliance, and regulatory investigations. Mishandling these areas can create serious problems for providers.
- Prevention saves money. Proactive compliance and early legal counsel cost less than fixing issues later. Providers face oversight from the Texas Health and Human Services Commission, Texas Medical Board, and federal agencies.
The Common Questions I Hear From Texas Providers
Do I need a lawyer if I’m just starting a small solo practice?
Yes, particularly when you’re starting out. Getting your entity structure, licensing, employment relationships, and basic compliance structure right from the beginning is much easier than trying to fix problems later. Even a small solo practice faces significant regulatory requirements under Texas law.
How often should I have my practice compliance reviewed?
I recommend an annual compliance review for most practices. Healthcare law changes frequently, and what was compliant last year might not be compliant now. An annual review helps you identify and address issues before they become serious problems.
Can a healthcare lawyer help if I’m already under investigation?
Absolutely. In fact, that’s one of the most important times to have legal representation. How you respond to an investigation can significantly impact the outcome. An experienced healthcare attorney can help you respond appropriately, protect your rights, and work toward the best possible resolution.
What should I do if I think my practice might have a compliance problem?
Contact a healthcare attorney promptly. Many compliance problems can be addressed through voluntary corrective action if caught early. Waiting or ignoring the issue typically makes things worse. Attorney-client privilege protects communications with your lawyer, so you can discuss the situation candidly.
Ready to Protect Your Practice? Contact Me Today
If you’re running a healthcare practice in Texas and need help with legal compliance, business transactions, regulatory matters, or any other healthcare law issue, I’m here to help.
At Brewster Law Firm, I work with physicians, nurses, therapists, hospitals, clinics, and other healthcare providers throughout Texas. Whether you’re starting a new practice, growing an existing one, or dealing with a specific legal issue, I can provide the support you need.
Don’t wait until a small issue becomes a big problem. Reach out today for a free consultation to discuss how I can help protect your practice and keep you in compliance with Texas healthcare laws. Your practice is too important to risk getting it wrong.