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
Ever since healthcare law emerged as a separate legal specialty, Clark Hill attorneys have been representing clients in all aspects of the industry. As in all other aspects of our practice, our philosophy is to use our years of experience, industry knowledge and legal experience to ensure our clients achieve their goals. We help position clients to withstand market changes and succeed over the long term.
Over the years, Clark Hill has successfully represented;
- Academic Medical Centers
- Ambulatory Surgery Centers
- Assisted Living Facilities
- Chiropractors & Chiropractic Clinics
- Dentistry & Oral Surgery Practices
- Durable Medical Equipment Companies
- Healthcare Systems
- Healthcare Management Companies
- Healthcare Trade Associations
- Health Plans
- Home Health Agencies
- Hospitals & Hospices (Nonprofit & For Profit)
- Intermediate Care Facilities
- Intermediate Care Facilities/MR
- Independent Diagnostic Testing Facilities (IDTF)
- Imaging Centers; Managed Care Companies
- Mobile Imaging Companies
- Multi-Specialty Physician Groups
- Pharmacies
- Physicians & Physician Groups
- Sleep Disorder Centers
Clark Hill prides itself on a team approach to legal issues - and healthcare law is no different. As part of this full circle philosophy, our healthcare clients have the ability to utilize the capabilities of the entire firm, whether your legal needs encompass antitrust compliance; corporate real estate matters; construction; engineering; employee relations; employee benefits; nonprofit tax issues; bond financing; litigation; including white collar criminal defense; immigration; and managed care contract review and negotiation.
Whether undertaking an acquisition or business expansion, assisting in the formation of new and innovative healthcare groups, or advising individual physicians on various legal matters, we seek to add value to our clients’ businesses. We are uncompromising in our drive to gain knowledge of our clients’ specialties. In addition, we are conscious of the pressures felt by our clients, and strive to achieve the desired results in an efficient, effective and cost-effective manner.
Healthcare law encompasses a broad spectrum of legal issues, and our attorneys have extensive experience covering a vast range of areas. A sampling of those areas includes:
Business Transactions
We represent nearly every healthcare entity imaginable in a variety of matters and transactions, including the creation of health systems; acquisitions or dispositions of facilities; structuring, creation, and implementation of joint ventures; anti-kickback and referral law issues; acquisition or creation of ancillary services; financing transactions; inurement and issues faced by tax-exempt healthcare entities; and securities offerings and related issues.
Certificate of Need
Obtaining a Certificate of Need from the state is essential for any new, merging or upgrading healthcare facility. With years of experience navigating governmental regulations at every level, Clark Hill attorneys can provide clients with the guidance they need to ensure they will be compliant. Whether it is for a new healthcare system or hospital, a long-term care facility, an upgrade or addition to an existing facility, or a merger between two existing facilities, Clark Hill attorneys can assist our clients in obtaining this crucial documentation.
HIPAA and Privacy Laws
Clark Hill attorneys have extensive experience working with the myriad privacy and security issues that are an integral part of any healthcare endeavor. We offer a wide variety of services designed to help our clients navigate the complex regulatory, security, privacy and transactional issues that come into play under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). From consulting with and educating our clients regarding standards and practices to guarantee HIPAA compliance, to the development of ironclad policies and procedures, to reviews of group health plans, documents and privacy notices, to establishing electronic medical records systems, to working with centralized health records clearinghouses at the state and federal levels, Clark Hill attorneys can make sure that both patient rights and recipient rights are protected at every level.
Litigation and Alternative Dispute Resolution
Our attorneys handle a wide range of healthcare litigation, including commercial litigation, medical liability disputes, and lawsuits such as mass torts and class actions. We counsel physician groups, hospitals, healthcare systems, rehabilitation facilities, laboratories and other healthcare related providers. In addition, we represent drug and medical device manufacturers and distributors in enforcement and litigation matters.
Medical Staff Relations
The myriad, complex legal issues that can come into play with medical staffing require a deep and widespread knowledge of not just healthcare law, but numerous other disciplines as well - labor and employment law, litigation, contracts and government, to name just a few. As part of Clark Hill’s holistic approach, every client can rely on our firm’s collective capabilities for any legal concern that may arise. Each of our attorneys has the experience and the knowledge to ensure that any medical staff issues will be addressed and resolved to their satisfaction. Clark Hill can assist you with medical staff concerns including: credentialing; certification; accreditation; staff processes, procedures and bylaws; staff disputes and litigation; peer and quality review policies and procedures; databank reporting and disruptive or impaired practitioners.
Medicare and Medicaid Reimbursement
Clark Hill attorneys have extensive experience advising clients on matters of Medicare, Medicaid and third-party reimbursement issues. Payment concerns are naturally of the utmost importance to every healthcare system, medical practice and care provider; Clark Hill is well versed in the many complex state and federal laws and regulations that impact this crucial component of the healthcare industry.
We work with a wide range of healthcare clients, from hospital systems to individual providers, assisting them with billing practices, making sure they remain in compliance with government and industry regulations, negotiating favorable settlements and establishing relationships with Medicare, Medicaid and other third-party payors. We assist our clients by proactively assessing and helping to prevent potential risk areas such as false claims, fraud and abuse and bad debt collection issues. Our team stays up-to-date on legislation and programs from Medicare and Medicaid regulations to rate setting and pay for performance, as well as advising on contemplated changes.
Operational and Regulatory Issues
Our extensive knowledge of state and federal regulatory requirements allows us to counsel clients on business organization, operations, transactions, joint ventures, mergers and acquisitions, and litigation.
Physician Issues
We advise physicians and physician groups in all manner of transactions, including the creation of healthcare entities. Our team is knowledgeable about healthcare businesses and assists in a variety of situations, from financing and construction needs to estate protection plans. We also routinely counsel clients throughout the licensing and credentialing maze.
Stark Law & Anti-Kickback Analysis
Clark Hill attorneys are ready to guide our clients through the complexities of federal and state fraud and abuse laws, including Stark and anti-kickback laws. We help clients interpret how the various laws and regulations impact everything from contracts, to electronic medical records subsidies, to joint ventures, to patient programs, to prompt pay discounts and co-pay waivers, tailored to each client’s specific practice. From simple, one-time explanations to complete, long-term legal analysis of ongoing issues, we are prepared to help our clients determine the proper, expedient and appropriate route.
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
