Regardless of size or structure, health care providers, payors, entrepreneurs and businesses must navigate a complex maze of Federal and state laws and regulations to remain economically competitive. Health care compliance continues to be an important part of the health care delivery system as the Federal government – and some state governments – are vigilant with enforcement activity. Maintaining compliance is critical to avoid significant financial exposure and public relations challenges – and potential litigation, criminal liability and/or administrative sanctions. Mergers and consolidations, patient and data privacy and security challenges, fraud and abuse enforcement, and reimbursement changes are ongoing issues in the health care delivery system. Successful parties in the health care delivery system will need to create and maintain legally compliant arrangements and relationships.
Saul Ewing Arnstein & Lehr’s health care industry clients confront these and many other issues on a daily basis and the firm’s attorneys are there to represent them and advise on corporate, transactional, regulatory, compliance, labor and employment, tax and employee benefits, energy and environmental, financing, litigation, and bankruptcy matters. Our attorneys regularly assist health care clients in developing and implementing sophisticated commercial arrangements relating to population health initiatives, relationships with managed care entities and third-party payors, mergers, acquisitions, sales, strategic engagements and affiliations, joint ventures, and new business formations. We understand the opportunities and challenges in the health care delivery system and routinely provide strategic planning advice on management and governance matters.
Typical issues for which our attorneys regularly provide legal advice include: HIPAA and state privacy laws; Federal and state fraud and abuse, anti-kickback and physician self-referral statutes and regulations; government investigations; corporate compliance; corporate practice of medicine and fee splitting; tax-exemption; antitrust; licensing, accreditation and survey-related matters; interactions with state and Federal regulators; and the Affordable Care Act.
Our firm is experienced in assisting clients with Certificate of Need applications and our attorneys have assisted academic medical centers, hospitals, long-term care facilities, ambulatory surgical centers and other facilities in obtaining state approval for new facilities, expansions and changes of ownership.
The firm also has a well-established reputation in professional liability defense. We represent a number of insurance companies issuing professional liability insurance in the health care industry. In Illinois, for example, we represent the largest provider of professional liability insurance to physicians in the state. Additionally, we provide counseling and representation to a number of hospitals and provider networks that are self-insured.
Saul Ewing Arnstein & Lehr’s Health Care team has experience advising:
- Academic medical centers and community hospitals
- Ambulatory surgery centers
- Ancillary health care providers (e.g., chiropractors, physical therapists, CRNAs and psychologists)
- Dentists and dental practices
- Federally qualified health centers
- Health information exchange providers
- Home health agencies
- Insurers and third-party payors
- Long-term care providers, nursing homes, skilled nursing facilities, assisted living facilities
- Medical device companies
- Physicians and physician practices
- Trade associations and professional certifying bodies
The activities of the firm’s health care lawyers include the following general subjects:
- Antitrust, unfair competition and trade regulation
- Compliance plans and programs
- Federal and state regulatory compliance
- Fraud and abuse, including Stark, False Claims Act, and Anti-Kickback
- Internal investigations
- Medical marijuana
- Arbitration and mediation
- Audits and investigations
- Licensure actions
- Litigation (complex professional, pharmaceutical drug, Title IX)
- Medical malpractice defense
- Certificate of Need
- E-health, telemedicine and EHR issues
- Employment and shareholder agreements
- Employee benefits and executive compensation
- Health care financing
- Insurance and risk management
- Integrated delivery systems
- Joint ventures
- Managed care contracting
- Medicare/Medicaid reimbursement and appeal
- Mergers and acquisitions
- Physician-provider agreements
- Practice formation and management
- Professional services arrangements
- Real estate
- Strategic affiliations
- Tax-exempt issues
Bankruptcy and Restructuring
Business and Finance
Labor and Employment
Real Estate Services
Regulatory, Compliance and Government
The group includes attorneys who have been named to the following lists:
- Chambers USA
- Super Lawyers
- The College of Labor and Employment Lawyers
The College of Labor and Employment Lawyers selects Fellows who have been in the field for at least 20 years and have proven to peers that they possess a high level of professional qualifications and character.
- Benchmark Litigation - State Litigation Star
Benchmark Litigation employs researchers who conduct interviews with litigators and their clients, examine recent casework handled by law firms and ask individual litigators to offer their professional opinions on peers.
- American College of Trial Lawyers Fellow
Fellowship in the American College of Trial Lawyers is extended only by invitation to trial lawyers whose professional careers have been marked by high standards of ethical conduct, professionalism, civility and collegiality.
- The Best Lawyers in America list
Inclusion in Best Lawyers is based entirely on peer review, employing a sophisticated, conscientious, rational, and transparent survey process designed to elicit meaningful and substantive evaluations of the quality of legal services.
- American Health Lawyers Association
- Healthcare Information Management Systems Society
- Pennsylvania Society of Health Care Attorneys
- America’s Health Insurance Plans
- Healthcare Financial Management Association