Health Care

Meeting the Challenging Demands of this Highly Regulated Industry

Health Care

Meeting the Challenging Demands of this Highly Regulated Industry

Overview

Many of our attorneys have experience in the public and private health care sectors, as members of Boards of health care non-profits and as commentators and participants on important health care policy issues. This practical experience in combination with our technical expertise enables us to understand and anticipate the impact of economic and legal changes in the industry and to help clients cost-effectively manage these issues.

We provide corporate, litigation and regulatory compliance support for our clients on a daily basis, develop and negotiate collaborative relationships and business ventures, provide transactional, tax and employment advice, assist clients with government relations strategies and help clients meet the challenging demands of this highly regulated and competitive industry.

The health care industry is subject to continuing and profound change as a result of persistent economic pressures. Due to dramatically higher health care and liability costs, market participants are constantly exploring many different ways of doing business. Novel business transactions, provider affiliations and attempts to transfer risk between participants in the system are ever-increasing.

At the same time, we appreciate that many of the legal and regulatory responses aimed at reforming the health care system have further increased the complexity of an already complicated set of rules and regulations, without necessarily providing relief from the underlying economic pressures. We understand the impact these changes have on our clients. Our goal is to provide practical and forward thinking guidance to help our clients successfully navigate through this shifting landscape.

Our health care team provides specialized services to a wide-range of health care clients. In addition, our health care group is supported by our litigation, corporate, insurance, employment and tax group attorneys in order to ensure that the many needs of our clients are recognized and met.

Our unique blend of professionals allows us to serve a wide range of clients throughout the Northeast and in New Hampshire, including:

  • Hospitals
  • Physician Group and Multi-Specialty Practices
  • Individual Physicians
  • Ambulatory Surgical Centers
  • Long Term Care Facilities
  • Health Insurance Companies/Health Management Organizations
  • Non-Profit & Federally Qualified Health Clinics
  • Medical Foundations
  • Other Medical Providers including Nurses, Physical Therapists, Psychologists and more
  • Employers

Strategic Compliance

We closely follow both the economic and the legal changes in the industry to anticipate and understand the needs of our clients and to provide efficient solutions in compliance with a host of federal and state regulations.

  • Represent physician groups, multi-specialty clinics, hospitals and ambulatory surgical centers in complying with a broad range of federal and state regulations including privacy and security, fraud and abuse, antitrust, EMTALA, certificate of need and licensing.
  • Secured approvals from the New Hampshire Health Services Planning and Review Board and Health Facilities Licensing for major health facility construction and renovation projects.
  • Represented large independent physician association in managing care to patients.
  • Assist major facilities and physician practices with HIPAA, Stark, Anti-kickback, HCQIA, ADA, Medicare/Medicaid and other regulatory compliance.
  • Defended facilities in Medicare deficiency investigations and actions.
  • Represent FQHC’s in matters relating to federal qualification under FTCA, HRSA compliance and audits, and community benefit and other grant compliance issues.
  • Represent health care providers and employers on compliance issues related to the enactment and implementation of the Patient Protection and Affordable Care Act

Corporate and Transactional Advice

We provide a full range of corporate support for health care providers, including day-to-day outside corporate counsel support, strategic joint venture advice (including negotiation of service arrangements), mergers and acquisitions, tax advice, corporate advice specific to non-profits, and practical advice on shifting risk by contract.

  • Successfully completed merger of two large specialty practices in the state.
  • Represented providers in planning, developing and negotiating joint venture arrangements with Hospitals and other providers to improve the quality of and access to health care.
  • Served as corporate and compliance counsel to physician practices, multi-specialty clinics, health care facilities and hospitals.
  • Successfully represented public health facilities before regulators, city officials and incourt to ensure the opening of new facilities, improving patient access to public health services in the community.
  • Negotiated resolutions to major contract disputes amongst payors and providers.
  • Represented a major health insurer in obtaining New Hampshire approval of its demutualization.
  • Successfully negotiated joint venture agreements between regional and rural hospitals and medical practices to the satisfaction of all parties.
  • Expanded health care services for uninsured New Hampshire families through a commercial transaction for one of New Hampshire’s largest community health centers.

Provider Defense

Our team has a wealth of experience providing advice to providers involved in professional malpractice cases, licensure actions, quality assurance, and peer review programs.

  • Years of experience defending providers in state and federal court medical malpractice actions.
  • Represented the American Medical Association and state medical societies on an appeal to the New Hampshire Supreme Court and the New Hampshire Medical Society on an appeal to the United States Supreme Court.
  • Represent physicians before the New Hampshire, Vermont and Massachusetts Boards of Medicine.
  • Defend nurses, psychologists, dentists and other providers before state licensing boards.
  • Represent physicians and hospitals in credentialing, privilege and medical staff disputes.
  • Represented providers in defending whistleblower, wrongful termination and other employment actions.
  • Represented hospitals and physicians’ groups in matters related to non-competition, dissolution and non-payment actions.
  • Defended hospitals and other providers to protect their non-profit and charitable treatment under local, state and federal tax laws.

Working with Government

Regulators play a critical role in interpreting the law, and we stay in close contact with both federal and state regulators in order to effectively represent our clients’ interests. If legislation is the best way to solve a problem, our health care group works closely with our government relations team to achieve a legislative solution for our client. 

  • Represented rural hospitals in negotiations with state and federal regulators and auditors to protect and expand reimbursements through federally funded and state administered programs.
  • Increased access to medication for low-income New Hampshire residents through the creation of the N.H. Medication Bridge Program and the establishment of a contract to administer the pharmacy benefit program for Medicaid patients.
  • Protected the tax-exempt status of educational and charitable organizations in New Hampshire.
  • Created and secured regulatory approvals for a new provider owned New Hampshire health insurance company.
  • Expanded the scope of vaccine requirements for children and adults in New Hampshire to include protection from varicella (chicken pox) and pneumococcal pneumonia.
  • Represented the providers of psychiatric services to patients at the New Hampshire Hospital and to the community for the renewal of a unique public-private partnership between the State of New Hampshire and community providers