Behavioral Health Care Law

Clark Hill’s Behavioral Health Care group has been and continues to be a leader in educating and consulting with behavioral health care providers to find money in the Affordable Care Act. We prepare and deliver presentations to behavioral health care providers on how parity works and what compliance with the privacy obligations of 42 C.F.R. Part 2 means. Our behavioral health provider clients get paid on claims, stay out of licensing trouble, and buy into effective and affordable compliance programs. Our Behavioral Health practice group is involved with cutting edge issues of developing an insurable and affordable behavioral health-oriented health information exchange, creating programs that integrate primary medical care with behavioral health, implementing new Centers for Medicare and Medicaid Services (CMS) regulations. We ensure that behavioral health gets a seat at the table of national health care reform.  

Intangibles

Our clients have the luxury of choosing from many accomplished law firms that deliver high quality and cost-effective legal services. What distinguishes our Behavioral Health Care team, however, are intangible factors – factors that benefit our clients. For example, our attorneys enjoy their work. We enjoy the challenge of meeting and exceeding an unbalanced burden of proof in the representation of the behavioral health care clients. In civil litigation, the recognized burden of proof is a “preponderance of the evidence” (more than 50 percent). However, due to negative stigma and hindsight bias to be successful in civil litigation, the burden of proof, in reality, is “clear and convincing.” These challenges, generated through the behavioral health delivery system, create excitement and trigger the talents and creativity of our Behavioral Health practice group.

The ultimate goal of each member of the Behavioral Health practice group is to become more than just an attorney for our clients. Our goal is to become a trusted counselor and advisor for all aspects of our clients’ work.

Hands-On Experience Translates into Expertise

Our Behavioral Health practice group represents behavioral health care providers in numerous states related to procurement, administrative law, contract disputes, licensing, claims disputes, Medicaid reimbursement matters, government regulatory compliance, malpractice defense, CMS sanctions, fraud and abuse, qui tam actions, healthcare financing, creation and operation of managed care organizations, labor and employment law services, corporate compliance program development, education, and maintenance. We are familiar with government-managed care contracts and the issues affecting all providers generated through ongoing governmental regulation.

Our Behavioral Health practice group participates in the policy development groups that focus on creating methodologies to integrate the delivery of medical and behavioral health care. You will find that the behavioral health care attorneys supply value-added services to clients because their experience in the behavioral health care arena has been hands-on.

Experience

Assisted clients on how to respond to growing demands to make their companies and products more sustainable, a goal increasingly being adopted by companies in the health care industry

Tracks regulatory developments for health care industry clients to provide early warning of significant new regulations or risks to a company's business, particularly concerning issues relating to FIFRA compliance for chemicals which claim to reduce Ebola, norovirus, and other viruses that are unlikely to have been explicitly testing in the original pesticide registration process 

Advised on methods of responding to regulatory agency and press concerns about the presence of "toxic" chemicals in products used by the health care industry

Commented on EPA rulemaking s for a trade association representing a segment of in the health care industry 

With assistance from  Kristi Gauthier,  Ed Hammond, Peter Domas and Bishop Bartoni, Kevin Hendrick and Nicole Tersigni successfully defended an insurance priority dispute, resulting in an extremely favorable judgment for firm client, United States Steel Corporation’s ERISA-governed Retiree Benefits Plan.  U. S. Steel Retirement Plan was joined as a third-party defendant in a pending dispute by a No-Fault Automobile Insurance carrier,  which had been sued by a healthcare service provider for unpaid patient attendant care fees.  The No-Fault Carrier claimed that the obligation to pay for these services under Michigan No-Fault law  fell to U. S. Steel Retirement Plan, which covered the patient (who was a former U. S. Steel employee).  Ed, Bishop, Kristi and Peter lent their expertise to Kevin and Nicole in interpreting alleged conflicting insurance priority provisions and explanations of benefits.  Kevin and Nicole crafted a legal argument that ultimately led to summary disposition in favor of U.S. Steel Plan, and against the No-Fault carrier, saving U.S. Steel Plan from payment of the healthcare fees, and also reimbursing U.S. Steel Plan for benefits it had earlier paid by mistake, out of priority.  As the No-Fault carrier had rejected the Case Evaluation award prior to the filing of cross motions for summary disposition, it also appears that attorney  fees are recoverable for our client.  Kristi and Ed on Employee Benefit law, Bishop on Michigan No-Fault law, and Pete on Health Care issues, proved to be unbeatable resources.

Antitrust and Trade Regulation - Reported antitrust decisions include the following: Pennsylvania Dental Association v. Medical Service Association of Pennsylvania, 815 F.2d 270 (3d Cir. 1987), rev’g, 632 F.Supp. 653 (M.D. Pa. 1986), cert denied, 484 U.S. 851 (1987); Pennsylvania Dental Association v. Medical Service Association of Pennsylvania, 745 F.2d 248 (3d Cir. 1984), aff’g, 574 F.Supp. 457 (M.D. Pa. 1983), cert. denied, 471 U.S. 1060 (1985).

Representation of rehabilitation entities.
Represented non-profit hospital in a conversion to for-profit status.
Represented hospital in merger transaction.

Managed Care and Health Care Industry Litigation - Counseled clients and litigated third party reimbursement and accounting for reimbursement issues.

Represented physician parties in corporate split-ups.
Represented major corporation in various acquisition and divestiture transactions involving developing technology.
Representation of medical billing companies.

Managed Care and Health Care Industry Litigation - Practiced before state and federal agencies and the courts relating to Medicare and Medicaid reimbursement issues.

Represented nephrology clinics in a merger into a publicly traded company.
Represented parties in sales of medical practices to hospitals and in divestitures of medical practices from hospitals.
Representation of medical staffs and hospitals on amendments to medical staff bylaws.
Formation of and counsel to medical professional corporations.

Antitrust and Trade Regulation - Antitrust litigation experience includes representing clients in the insurance, health care, soft drink, construction, manufacturing, hardware and building materials industries.

Formation of joint ventures between hospitals and physicians.

Managed Care and Health Care Industry Litigation - Litigated issues related to institutional providers’ Medicaid cost reports.

Represent healthcare insurers, third party administrators, managed care organizations and others in contractual, business and other disputes. Representation includes counseling clients and litigating issues regarding payments, accounting for payments, third party administration and self-insured health plan issues, fraud claims, among others

Antitrust and Trade Regulation - Lead Counsel in an antitrust case which successfully put an end to a decade’s long boycott against one of the largest dental insurers in the country.

Managed Care and Health Care Industry Litigation - Litigated provider participation status under the Medicare program.

Counsel to mid-market health care companies including cancer treatment centers, dialysis centers, sleep labs, and ambulatory surgery centers providing lead counsel and coordinating legal counsel on a wide array of matters including corporate matters, operations, acquisition and divestiture transactions, joint venture projects, corporate governance, business planning and financial transactions, and legal compliance.

Formation of joint ventures among physicians.

Health Care Industry Litigation - Participated and litigated in several federal bankruptcy and state court receivership proceedings of hospitals.

News
Clark Hill Attorneys Named to DBusiness Magazine's 2020 Top Lawyers ListClark Hill PLC Receives National and Regional Tier 1 Rankings in the 2020 Edition of Best Lawyers “Best Law Firms”Clark Hill Attorneys Named 2019 Michigan Super Lawyers & Rising StarsClark Hill Attorneys Named 2019 “Leaders in their Field” by Chambers USAClark Hill Strasburger Member Corinne Smith Named to Trinity University Alumni Association BoardHealth Care Attorney Kevin Wood Featured in Texas Medical Association Article on Investments in Medical PracticesClark Hill Attorney Andrew B. Turk Featured in AZ Business Leaders 2019Clark Hill PLC Receives National and Regional Tier 1 Rankings in the 2019 Edition of Best Lawyers, “Best Law Firms” Sixty-Six Clark Hill Attorneys Named 2018 Michigan Super Lawyers & Rising Stars143 Clark Hill Attorneys Selected for Inclusion in the 2019 Edition of Best Lawyers in AmericaClark Hill Attorneys Named 2018 “Leaders in their Field” by Chambers USAClark Hill Attorneys to Present at the 2017 MCMCFC Spring Management ConferenceClark Hill Princeton Welcomes Attorney Jeanne StiefelClark Hill Attorney Andrew B. Turk Named Top AZ Business Leader by AZ Business MagazineClark Hill Attorney Gerald “Jud” DeLoss to Present Behavioral Health Managed Contracts Webinar on July 14, 2016Clark Hill Attorney Gerald “Jud” DeLoss to Present at the American Health Lawyers Association Annual Meeting in Denver, CO, on June 28, 2016Clark Hill Attorney Andrew B. Turk Named 2016 Top 100 Lawyers in Arizona by AZ Business MagazineClark Hill Attorney Gerald “Jud” E. DeLoss to Teach Health Data Class at Northwestern University Law School February 4, 2016Clark Hill Attorney Gerald “Jud” E. DeLoss to Present at American Health Lawyers Association Physicians and Hospitals Law Institute on February 8, 2016 in Austin, TXClark Hill Health Care Attorneys to Present “The Economics of Medical Practice Under HIPAA/HITECH” Webinar Sixty-Six Clark Hill Attorneys Selected for the 2015 Super Lawyers Business EditionTwenty-Eight Clark Hill Attorneys Named to DBusiness Magazine's 2016 Top Lawyers ListSixty-Five Clark Hill Attorneys Named to Michigan Super Lawyers 2015 ListClark Hill Attorney Scott D. Braun Presented at Florida Society for Healthcare Risk Management & Patient Safety Annual Meeting August 14, 2015Clark Hill Attorney Gerald “Jud” E. DeLoss to Present at HMFA Webinar on MACRA Legislation Overview on September 15, 2015
Articles
Strict Rules Addressing Opioid Crisis Create Risks for Physicians - Healthcare Risk Management MagazineCorinne Smith quoted in Medical Economics - "Dealing With EHR Buyer's Remorse"Corinne Smith quoted in Health IT Security - "AI, IoT, Medical Devices Top Health Cybersecurity Predictions for 2019"Corinne Smith quoted in Health IT Security - "Biggest Challenges, Lessons Learned from Health Cybersecurity in 2018" Andrew Turk Named 2017 Top AZ Business Leader by AZ Business MagazineRelationships & the Law Today: Protecting Your Interest in Shared Assets after Blumenthal v. Brewer - Windy City Times, October 19, 2016Relationships & the Law Today: Married on Sunday, Fired on Monday: Recent Developments in Employment Law - September 21, 2016Jud DeLoss Quoted in Alcoholism & Drug Abuse Weekly: Illinois residents with good insurance targeted by Florida provider – June 13, 2016Gerald DeLoss Quoted in "How Electronic Health Records Can Hurt You in Malpractice Suits" By InsureonTop 10 Health Law Issues 2016 by AHLA Connections Health Attorney Gerald DeLoss: Data Sharing, Use Agreements in the Midst of an Evolution (Q&A) in FierceEMR - February 5, 2016Gun safety: HIPAA change allows providers to report on some mentally ill patients No Pharmacist Duty to Monitor Patient Prescription History by Courtney Posnik in IAHA Magazine Overpayments: Key Issues Physicians Should Consider, Legal Matters, The ChicagoDoctor.com - Part 2 of 2Overpayments: Key Issues Physicians Should Consider, Legal Matters, The ChicagoDoctor.com - Part 1 of 2Relationships & Law Today: Healthcare Decision-Making for the LGBTQ Community - August 12, 2015The Hospital Readmission Reduction Program: Fraud and Abuse Concerns - Spring 2015Story Behind 'The SGR Fix' in 900 Words or Less - Healthcare Michigan, May 2015Patient-Physician Confidentiality: 'Til Death Do Us Part?A Crystal Ball: Managed Care Litigation in Light of the Patient Protection and Affordable Care Act, The Health LawyerHealth Care Without Borders in DBusiness, November-December 2014Thinking of Investing In, or Renting Space In, an ASC? Have You Taken Compliance into Consideration?"Not-So-Friendly Competition" in Sleep Review: The Journal for Sleep SpecialistsHow to Legally Break Up With Your PatientManagement and Third-Party Billing CompaniesHospital Incentives to PhysiciansManagement and Third-Party Billing Companies Hospital Incentives to PhysiciansReporting Post-Operative Pain Management Procedures in 2013A Survey of State Prompt Pay Laws, Part IISo You're Thinking of Getting into the Business of Healthcare? Here Are the Top 5 Things You Need to KnowA Survey of State Prompt Pay Laws, Part IWhat You Need to Know About the Supreme Court's Decision on Health Care ReformSocial Media Policies: Do I Really Need One?Five Steps to Protect Your Organization from HIPAA AuditsThe Required Hospital Standard Charge Publication That You Probably Missed, American Health Lawyers Association Hospitals & Health Systems RXAnesthesiologists Should Beware of HIPAA Audits
Presentations
Webinar: The Economics of Medical Practice under HIPAA/HITECHWebinar: Entrepreneurial Medicine: Opportunities to Enhance Your Practice and Bottom LineWebinar: Physician Compensation Reform: How You Will Get PaidPhysician Webinar Series
Media
Illegal Pill Presses: An Overlooked Threat To American PatientsNursing Home Litigation with Andrew Turk By The Legal Broadcast Network