Ts o u l e s , S w e e n e y, Tsoules, Sweeney, Martin & Orr, LLC Ts o u l e s , S w e e n e y,
M a r t i n & O r r, L L C M a r t i n & O r r, L L C
The delivery of public and private sector mental and Tsoules, Sweeney, Martin & Orr has established a
behavioral health care has become increasingly com- reputation for excellence in health care law. We
plex. Since we exclusively practice health care law, offer our clients innovative, refreshing and
we are able to provide our clients with solutions to
practical solutions to their health care legal
meet this challenge. Our expertise includes:
problems that enhance their bottom line. With
• Legal issues surrounding the delivery of behav- seventy years of health care experience, our
ioral health rehabilitative services (“wraparound”) attorneys pride themselves on providing our
to children and adolescents under Medicaid and
clients with quality legal services in a timely,
the Pennsylvania HealthChoices Program
• Regulatory, corporate and provider contracting
responsive and cost-effective manner. We do not Public and Private
believe in old school thinking or taking a cookie
issues in connection with behavioral health man-
cutter approach to legal services. We listen to our Sector Mental and
aged care organizations
• Professional licensure disciplinary action repre-
clients and develop innovative and practical
solutions. As a specialized firm, Tsoules,
Behavioral
sentation regarding behavioral health care provid-
ers
Sweeney, Martin & Orr attorneys develop solid Healthcare Legal
relationships with their clients that enable them
• Fraud and abuse and regulatory compliance in- to tailor their legal services to meet each client’s Representation
cluding development of compliance programs and specific needs and goals and to provide them with
Medicare and Medicaid audit and enforcement effective legal representation. Our attorneys have
• Corporate and professional practice formation and the experience and knowledge to assist our clients
organizational advice regarding corporate govern- in providing a range of legal services from the
ance and formation as well as the business aspects most simple to the sophisticated.
of health care delivery in the public sector
• Reimbursement counseling, payor negotiations
and payment disputes involving DPW and com-
mercial payors
• Health information technology, including DPW
Thomas E. Sweeney
regulations, privileged communications and
HIPAA privacy issues
29 Dowlin Forge Road
Exton, PA 19341
• Substantive and procedural aspects of health care
facility licensure
Tel.: 610.423.4200
Fax: 610.423.4201
• Minors and Parental rights to consent to mental
tsweeney@tshealthlaw.com
health treatment and confidentiality of records
under Act 147 and DPW Regulations
In addition, we offer a Prepaid Legal Plan for
an annual fixed fee that allows for on-going
cost-effective access to legal consultation re-
garding covered services.
Complex Private and Public Sector Representative Mental and Why choose TSMO?
Mental and Behavioral Health
Behavioral Health Projects
Representation
• We help our clients meet their
• Successfully navigated the DPW and
Our private and public sector legal goals within legal guidelines
Bureau of Program Integrity audit
services are led by Thomas E.
and review process which resulted in • We provide comprehensive
Sweeney, a healthcare attorney
a favorable settlement of alleged over-
with over 25 years experience in regulatory analysis to insure
payments regarding wraparound ser-
advising private and public sector that all relevant federal and
vices and partial hospitalization
mental and behavioral health pro-
services state regulatory guidelines are
viders navigate complex and con-
• Developed Independent Service met, including fraud and abuse
fusing legal requirements.
Organization documentation for and tax-exemption require-
Our services uniquely combine le-
providers serving MH/MR consumers ments
gal, regulatory, business, and stra-
tegic planning expertise to assist • Routinely advised mental and behav-
• We help agencies comply with
our clients in developing and imple- ioral health providers regarding com-
plex and often confusing legal re- governmental and commercial
menting innovative and legally
compliant strategic collaborative sponsibilities related to consent for payor guidelines
transactions. minors and parents under Act 147
• We develop all corporate and
• Routinely assisted mental health pro-
transactional documents neces-
viders regarding privacy and confi-
dentiality requirements for psychiat- sary to implement joint
Thomas E. Sweeney ric and mental health records includ- ventures or other business
ing special requirements for arrangements
tsweeney@tshealthlaw.com
subpoenas
Tom’s practice focuses on representation of • We provide on-going legal ad-
private and public sector mental and behavioral • Formed and advised a statewide
vice regarding complex consent
health providers and managed care organiza- multi-agency, provider-controlled
tions. He represents agencies, community men- HealthChoices behavioral health man- and confidentiality require-
tal health centers, base service units and behav- aged care organization; facilitated a ments for mental and behav-
ioral health managed care organizations. He has
comprehensive reorganization and ioral health
extensive experience representing behavioral
health rehabilitative service wraparound provid-
sale of the organization for $40 million
ers in DPW audits and Medicaid Fraud Control dollars
Unit investigations. In addition, he has assisted
agencies and psychologists regarding licensure
and reimbursement matters.