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HEALTH CARE PRACTICE
We
serve as general or special counsel to a broad array of
institutional and individual health care providers. We also
act as special New York and regional counsel to several
national health care systems whose general counsel are based
outside the state. Among our clients are multi-provider
systems, integrated delivery networks, hospitals, health
maintenance organizations, health care insurers, independent
practice associations, nursing homes, home health care agencies,
hospices, clinical laboratories, primary care clinics, ambulance
companies and other emergency services organizations, and
numerous individual physicians and multi-specialty group
practices.
Our statewide practice has allowed us to gain a unique perspective
and special insight into the position and strategy of the
party sitting across the table. This results from representing
different clients in different parts of the state. For example,
in one part of the state, we may represent integrated delivery
systems in negotiations and disputes with third-party payors.
In other markets, we may represent third-party payors. Our
clients benefit from this valuable experience.
Special areas of experience include the following:
Formation of Multi-Provider Systems and Integrated
Delivery Networks. We have assisted clients in
developing and implementing vertical and horizontal integration
strategies. We have addressed these issues across a wide
spectrum, ranging from primary-care-based rural networks
to multi-provider systems operating in large metropolitan
areas. We have also assisted groups of physicians, individual
physicians and small practices in evaluating and developing
various group practice and affiliation options. We have
unique experience in developing governance and business
models that meet the special demands of New York law.
Health Insurance and Third-Party Payors.
We are general counsel to a +300,000-member HMO, a 2000-physician
IPA and PPO, and a number of specialty IPAs. We have handled
many complex contracting issues on behalf of payors and
providers. We have helped clients to develop direct-contracting
strategies with self-insured groups.
Corporate and Regulatory Compliance. We
have addressed a full range of compliance issues, from the
preparation of compliance plans to the defense of investigations
and enforcement proceedings. We carefully follow and monitor
federal and state investigatory and prosecutorial initiatives.
We stay current with the most recent developments in such
areas as fraud and abuse, “Stark” anti-referral
rules, accreditation standards, HIPAA, and intermediate
sanctions, and counsel our clients in these areas of heightened
exposure. We are frequently called upon to represent hospitals,
nursing homes, HMOs, laboratories and individual practitioners
in defending regulatory enforcement proceedings, some of
which threaten licenses and operating certificates.
Regulatory Issues. We have worked for many years
with the New York State Department of Health, the Centers
for Medicaid and Medicare Services, and other regulatory
agencies with jurisdiction over health care providers. We
have successfully represented clients before these agencies
on a wide range of regulatory issues. We are experienced
in all regulatory matters that confront health care providers,
including certificate of need review and third-party reimbursement.
Conventional and Exempt Financing. We have
represented clients in connection with conventional and
tax-exempt financing involving the Dormitory Authority of
the State of New York, HUD, private bond insurers and banks.
These transactions range from routine lines of credit to
complex, obligated group financings involving hundreds of
millions of dollars.
Catholic Health Care Providers. We represent numerous
Catholic health care providers, including those who participate
in multi-provider health care systems. We have substantial
expertise in managing and solving problems involving the
interrelationship of the Canon Law of the Roman Catholic
Church with the civil law of the State of New York. We are
also experienced in addressing the challenging issues that
arise when providers sponsored by the Catholic Church joint
venture with other-than-Catholic organizations.
Joint Ventures. We have helped to create
a variety of workable joint venture relationships, while
minimizing risks in the areas of Medicare/ Medicaid fraud
and abuse, provider self-referral, antitrust and tax exemption.
Tax Issues. We have deep and varied experience
in handling the tax issues confronting tax-exempt health
care providers, including tax exemption, intermediate sanctions,
conflict of interest and insider rules, unrelated business
income tax and charitable giving. We have also counseled
clients in connection with many other specialized tax questions,
such as assessments levied upon payments made to off-shore,
captive insurance companies.
General Hospital Law. As general counsel to many
hospitals, nursing homes and clinics, we regularly deal
with all of the day-to-day operational problems requiring
legal advice and guidance, such as medical staff bylaws,
credentialing, vendor contracts, insurance and patient care
issues.
Physician Practices. We serve as general
counsel to a large number of physician group practices,
both large and small. We offer responsive and comprehensive
legal services in virtually all areas affecting their operation,
including shareholder, partnership and operating agreements,
provider and vendor contracts, leases, financing, tax planning,
employment matters, compliance, and professional licensure
and discipline.
Emergency Medical Services. We represent
a variety of providers who deliver emergency medical services,
including Regional Emergency Services Councils, ambulance
companies and similar organizations.
Litigation. In those instances in which
resort to the courts becomes necessary, we provide our clients
with expert and effective trial counsel. |
