Hospitals not only provide acute care services, but they have often needed it themselves during the last decade as the myriad forces that comprise the U.S. health care system have boldly converged at the most critical point in the delivery system.
Hospital administrators have been forced to rapidly adapt to many challenges, addressing issues across the health care spectrum involving statutory and regulatory compliance, corporate compliance, shrinking reimbursements, competition, managed-care contracting, new contractual relationships, and the need to develop a more efficient delivery model.
The attorneys in our Health Systems and Hospitals Practice Area have the knowledge and experience to provide guidance related to the day-to-day operational, business, and regulatory issues involving patients, medical staff, medical records, financing, reimbursement, tax, contracts, and the numerous other matters that regularly arise.
We are also adept at handling special projects, having served as special counsel in hospital affiliations and reorganizations in which we have lent our considerable experience in not-for-profit structuring and governance matters. We have addressed health care issues involving Catholic versus non-Catholic relations; structured, evaluated and dismantled clinical affiliations; and developed integrated delivery systems involving hospitals and physician services.
In addition, our creativity, negotiating ability, and depth of experience in health care and financial reorganization enabled us to perform the country’s first Chapter 11 reorganization of a hospital on a stand-alone basis, rather than through sale or merger. The hospital – the oldest and largest in central New York – dealt with more than $100 million of claims, established and funded a medical malpractice trust, and resolved complexities involving a self-insured workers’ compensation program.
In essence, whether it’s daily operational issues or a special project, we are the go-to firm for health care systems and hospitals seeking legal wellness in all regulatory, operational, and business arenas.
Public and Private Health Care Systems and Hospitals
Regulatory Compliance. Our health care attorneys have developed expertise in the federal laws and regulations pertaining to health care providers and their operations. This includes all facets of the Medicare program, the federal aspects of Medicaid participation, Medicare and Medicaid reimbursement appeals, conduct of appeals before the Provider Reimbursement Review Board (PRRB), fraud and abuse, antitrust, corporate compliance, anti-kickback, and Stark I and II regulations.
We routinely advise clients on the state of their compliance relating to professional conduct, professional or institutional licensure, accreditation, and other matters. Our attorneys also regularly track proposed regulatory changes that affect the health care industry, and actively pursue an ongoing dialogue with governmental regulators.
In addition, we can assist in regulatory matters relating to medical records and patient confidentiality, including those involving the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which has spawned numerous regulations intended to assure the privacy of individually identifiable health information. We have extensively lectured on the HIPAA privacy and security rules throughout New York State both before professional organizations and for individual clients and client groups. Our attorneys are knowledgeable in all aspects of HIPAA, and presently provide advice and assistance to more than 40 clients in the development of HIPAA compliance programs.
Medical Staff Issues. Matters relating to human resources are a universal concern across every industry type, and the attorneys in our Labor and Employment Practice Area have extensive experience assisting in a wide array of legal concerns in this area. Our attorneys can also help in handling the issues unique to health care, including credentialing, privileging, peer review, privilege termination, and staff bylaws. Our Immigration Practice Area can help employers attract and retain talented employees from outside the U.S.
Business Issues. We are experienced and skillful in providing all aspects of business law and transactional services, including provider agreement review, analysis and negotiations; business tax planning; mergers, affiliations, joint ventures and divestitures; enforcement action response; policy and procedure development; assistance regarding the Certificate of Need process; patient accounts management and collection; and structuring a waste disposal system.
We have significant experience in dealing with health insurance companies as a result of our representation of large provider groups who have moved to self-funded or limited-risk insurance plans. Our experience handling managed care contracting issues is well known, including matters relating to the shift in economic risk and intrusions of the physician/patient relationship.
We provide all forms of real estate assistance related to the entire spectrum of services, from medical office complexes development to sophisticated commercial lease transactions.
Patient Issues. We address concerns related to treatment decisions, professional ethics, confidentiality, medical records, and other matters directly related to patient care.
Litigation. Disputes of many kinds can arise in the business world, and our Litigation Practice Area can help resolve them. We are experienced in handling conflicts relating to health care, including professional disciplinary matters, fee reimbursement by the federal government and private insurers, and regulatory violations. Our Health Systems and Hospitals Practice Group is well versed in assisting clients in resolving these issues in an expedient and efficient manner.