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
Healthcare Law
Leader
Healthcare Law
Director
Healthcare Law
Healthcare providers strive to deliver quality care to patients. In fact, quality care is their primary mission. By being a part of one of the most highly regulated industries, providers must face a multitude of other obstacles that demand their attention. From complying with federal and state fraud and abuse laws, to ensuring the privacy and security of patient information, to being prepared should federal or state agencies knock at the door, the challenges can be daunting.
Clark Hill’s Healthcare team offers preventative advice so that our clients can maintain their focus on quality care. Our knowledge of the latest challenges facing healthcare providers allows us to offer practical solutions that enable providers to focus on their patients—the ones who matter most. We offer comprehensive legal services in nearly every sector of the healthcare industry with one goal in mind: positioning our client to withstand market change and achieve long-term success.
Whether for hospitals and healthcare systems, physician groups, surgery centers, long-term care facilities, or any other type healthcare entity, we help clients handle complex business and transactional matters, such as the creation of health systems, acquisition or development of ancillary services, acquisitions and dispositions of facilities, and negotiating and structuring joint ventures. We also advise on anti-kickback and self-referral issues, financing transactions, securities offerings, and inurement or other issues faced by tax-exempt entities.
We endeavor to gain a complete understanding of our clients’ specialties, ever-conscious of the pressures they face. We are uncompromising in our drive to achieve the desired results efficiently and effectively. When advising on a Medicaid billing issue, assisting with Medicare provider enrollment and reimbursement, or advising individual practitioners on various legal concerns, we commit to adding value across all legal disciplines. As an example, we maintain productive working relationships with state agencies to better represent our clients, including state licensing boards for physicians, nurses, pharmacists and pharmacies, as well as state Medicaid programs or federal and state enforcement agencies.
Our team members have worked in healthcare as former in-house counsel and in other administrative or finance roles, which allows us to help clients understand how legal issues can intertwine with operational processes. With support from our firmwide commercial law practice, we provide quality representation as needed and with ease. So regardless of the matter at hand, we offer solutions and alternatives that make sense for our clients’ day-to-day operations.
This solution-oriented attitude extends to commercial litigation, as well as to white collar, medical products liability, and malpractice defense, particularly in long-term and elder abuse situations. Notably, two former healthcare fraud and abuse prosecutors are members of our team and assist clients faced with investigations and prosecution.
Our clients include:
- Academic medical centers
- Ambulatory surgery centers
- Assisted living facilities
- Chiropractors and chiropractic clinics
- Dentistry and oral surgery practices
- Drug and alcohol abuse treatment centers
- Durable medical equipment companies
- Healthcare systems
- Healthcare management companies
- Healthcare trade associations
- Home health agencies
- Hospice
- Hospitals (nonprofit and for profit)
- Intermediate care facilities/MR
- Independent diagnostic testing facilities (IDTF)
- Imaging centers
- Long-term care facilities
- Management service organizations
- Mobile imaging companies
- Pharmacists and pharmacies
- Physicians, physician groups, and multi-specialty physician groups
- Sleep treatment centers
Experience
Commented on EPA rulemaking s for a trade association representing a segment of 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
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.
Managed Care and Health Care Industry Litigation - Practiced before state and federal agencies and the courts relating to Medicare and Medicaid reimbursement issues.
Formation of joint ventures among physicians.
Represented major corporation in various acquisition and divestiture transactions involving developing technology.
Represented non-profit hospital in a conversion to for-profit status.
Represented nephrology clinics in a merger into a publicly traded company.
Represented hospital in merger transaction.
Health Care Industry Litigation - Participated and litigated in several federal bankruptcy and state court receivership proceedings of hospitals.
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 - Counseled clients and litigated third party reimbursement and accounting for reimbursement issues.
Formation of and counsel to medical professional corporations.
Formation of joint ventures between hospitals and physicians.
Representation of medical billing companies.
Representation of medical staffs and hospitals on amendments to medical staff bylaws.
Representation of rehabilitation entities.
Represented parties in sales of medical practices to hospitals and in divestitures of medical practices from hospitals.
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).
Antitrust and Trade Regulation - Antitrust litigation experience includes representing clients in the insurance, health care, soft drink, construction, manufacturing, hardware and building materials industries.
Represented physician parties in corporate split-ups.
Managed Care and Health Care Industry Litigation - Litigated provider participation status under the Medicare program.
Managed Care and Health Care Industry Litigation - Litigated issues related to institutional providers’ Medicaid cost reports.
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.
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
