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Healthcare

Our attorneys have represented healthcare providers for years, including hospitals and national health systems, multi-state ancillary providers and physician practices.  This diverse base of experience provides our attorneys with insight to the entire spectrum of healthcare providers.

The transformation of the healthcare industry to accountable care and quality reimbursement presents a sea of change, where novel opportunities and challenges are constantly emerging.   The continued consolidation of the healthcare industry is taking some unexpected turns; however, the drivers of accountable care often appear to be physicians, and they are increasingly recognizing this potential power.  Hospitals are being pushed to cut costs in ways that are exceptionally challenging– the successful are embracing technology and recognizing ways to provide value-based compensation to their physicians and employees and to joint venture appropriately with other healthcare providers. The government continues to struggle with accountable care implementation, but it is also beginning to develop regulatory pathways for increased consolidations that previously were  deemed suspect under antitrust, physician referral, and anti-kickback laws.

The merging of accountable care and quality reimbursement, made possible through advances in technology, creates an excellent opportunity for our attorneys to provide meaningful, practical guidance to providers that are willing to engage in an interesting and innovative change for the healthcare industry.

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CORPORATE AND TAX
  • Development of bylaws, shareholder agreements, operating agreements, policies, and other governance documents
  • General advice and counsel to Boards and senior staff
  • Managed Care Contracting and Network Formation
  • Development and negotiation of professional and administrative services agreements
  • Advice and counsel on all types of nonprofit, tax exempt entities that provide healthcare services, including 990 reporting, unrelated business income tax, permissible lobbying, 501(r) requirements, and joint ventures
  • Advice and counsel on for-profit healthcare entities taxed under Subchapters S, K, or C

Attorneys: Clay GraysonLisa ThomasCallie Campbell

TRANSACTIONAL, MERGERS AND ACQUISITIONS
  • Drafting and negotiation of agreements for physician practice acquisitions, representing both health systems and practices
  •  Drafting and Negotiation of joint venture agreements among healthcare providers across the continuum of care, including joint ventures for diagnostic and therapeutic services, ambulatory surgery centers and  dialysis centers
  • Representation of parties in acquisitions of Hospitals, Medicaid managed care organizations, and multi-state assisted living and nursing home organizations
  • Representation of parties in local and multistate acquisition of surgery centers
  • Representation of parties in numerous acquisitions of durable medical equipment providers and diagnostic testing facilities
  • Lead counsel in merger and formation of physician practices, including urology, oncology, family practice and obstetrics and gynecology, and other multispecialty groups.

Attorneys: Clay GraysonLisa Thomas

REGULATORY/ COMPLIANCE
  • State regulatory counsel to multistate, for-profit health system,
  • Operations Counsel to hospitals and health systems
  • Stark, Anti-Kickback and other Fraud and Abuse laws
  • Reimbursement and Billing Compliance
  •  Corporate and regulatory counsel to large multi specialty medical practices and physician practice plans
  • Representation of healthcare providers in RAC audits, payment disputes and overpayment investigations by Medicare and Medicaid contractors,  and private third party payors, ranging from tens of thousands of dollars to multi million dollar claims
  • Preparation and updating of HIPAA privacy and security plans
  • Preparation and updates of corporate compliance plans
  • Representation of providers in OCR investigations and management and reporting of data breaches
  • Meaningful Use and EHR Incentives
  • HIPAA and HITECH Privacy and Security
  •  Compliance with state licensing laws and regulations and corporate practice of medicine restrictions
  • Patient Data  and Protected Health Information
  • Protection, Defense, and Breach Management
  • Common Rule
  • IRB Consultation and submissions

Attorneys: Lisa ThomasCallie Campbell 

HOSPITAL AND HEALTH SYSTEMS

Our healthcare attorneys provide operational and regulatory advice to hospitals and health systems, ranging from small community hospitals to large nonprofit hospitals, academic medical centers and for profit health systems.  As healthcare providers respond to the sweeping legislative changes in recent years, our lawyers have represented purchasers and sellers in M&A transactions, as well as equity investors and lenders.   In addition to negotiating and drafting the transactional documents, our lawyers perform due diligence, risk analysis and mitigation, and tax structuring with respect to the joint venture, consolidation, sale and purchase of healthcare providers.  Outside of the transactional environment, our lawyers serve as operations counsel, advising clients on state licensing laws and regulations, federal conditions of participation, Joint Commission rules, and provider-based rules and regulations, managed care contracting and reimbursement, and frequently interface with state and federal agencies.

Attorneys: Lisa ThomasCallie Campbell

ANCILLARY PROVIDERS

We have advised ancillary healthcare providers such as independent diagnostic testing facilities, ambulatory surgery centers, home health agencies, imaging centers, psychiatric hospitals, clinical laboratories, durable medical equipment, prosthetic and orthotic suppliers, nursing homes, assisted living facilities, lithotripsy companies and dialysis providers.  In response to the changing landscape of healthcare, these providers have consolidated, merged, acquired other providers, and entered into strategic joint ventures with other healthcare providers.  Our lawyers have guided our healthcare clients in these transactions, by applying business-minded practical solutions while navigating the state and federal regulatory requirements of Stark, anti-kickback, and other fraud and abuse laws, as well as state laws regulating the operations and relationships of these healthcare providers.  These strategic joint ventures range from the development of travel surgery programs to joint ventures between these providers and physicians to provide ancillary services.   We assist ancillary providers on a regular basis with operational issues, such as federal enrollment and participation standards, Medicare and Medicaid reimbursement, and compliance with state licensing law and regulations.  We have frequently interacted with state and federal agencies to seek advisory opinions and less formal advice, including the Centers for Medicare and Medicaid and their regional contractors, and the OIG.

Attorneys: Lisa ThomasCallie Campbell

PHYSICIAN GROUPS

Our clients include large and small primary care multi-specialty physician practices, faculty practice plans, and single specialty and hospital-based physician groups.  As with institutional clients, our physician clients have been active in the mergers and acquisitions arena.  We have advised multiple physician groups on the sale of their practices to hospitals and other investors, negotiation of physician compensation plans, often working with valuation firms to ensure proposed compensation complies with Stark and state physician referral laws.  We have frequently advised clients on the application of corporate practice of medicine restrictions when acquiring physician practices or engaging physician services.  Other practices seeking to remain independent have consolidated, often forming large single specialty, primary care or multi-specialty practices.   We have assisted with all aspects of these transactions ranging from asset acquisition, due diligence, negotiation of employment arrangements, and anti-trust analysis.  Other physician groups seeking to stake their ground in the world of accountable care are forming networks to manage care in a fee for value world.   For these diverse physician groups we assist with the development of physician compensation plans, advise governing boards, develop governing documents, develop and update corporate and HIPAA compliance plans and keep them updated on changes in Stark, anti-kick back and other fraud and abuse laws.

Attorneys: Lisa ThomasCallie Campbell

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