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Health Care

Providing quality legal services to health care companies regarding business and regulatory matters.

About Our Practice

Federal and state regulation of health care providers, suppliers, and other industry participants has become increasingly complex in recent years. On top of this, enforcement tactics of government agencies can be both confusing and intimidating for these organizations. Our Health Care Practice Group focuses on guiding clients through the compliance maze, helping all varieties of care companies understand and manage their approach to patient care within government standards.

Lawyers in the Health Care Group of Hall Booth Smith also have extensive experience in business litigation, administrative hearings, and alternative dispute resolution involving health care companies.

Because the implementation of regulations and policy are the direct result of federal and state political processes, the Health Care Group also provides legislative strategy, drafting, and interpretation services to its clients.

We represent clients in many areas of law that affect health care providers and other kinds of companies in the industry, including:

  • Antitrust issues
  • Business/ Strategic Planning
  • Compliance programs (including development, revision and training)
  • Entity Formation
  • Internal investigations
  • Managed care strategies and contracts
  • Medical staff credentialing and corrective action
  • Medicare and Medicaid fraud and abuse
  • Mergers and acquisitions, affiliations, and joint ventures
  • Patient care, informed consent, and medical records issues
  • Rules and regulations under HIPAA (including privacy, transactions, and security)
  • Hospital integration strategies
  • Provider licensure, certification, and accreditation (including disciplinary actions)
  • Reimbursement issues
  • Tax-exempt status (application and compliance)

Health Care Litigation

We vigorously represent clients in a wide range of lawsuits, disputes and investigations, including Qui Tam actions arising from allegations of Medicare/Medicaid fraud through whistleblower claims under the False Claims Act, breach of contract actions between hospitals, physicians and/or vendors, including Pharmacy Benefit Managers (PBMs), patient care and medical malpractice issues and claims created by allegations of lack of informed consent, failure to establish or document medical necessity, patient privacy, and data and records protection. We conduct internal reviews and investigations for our clients to uncover facts and preserve important evidence, and we assess risk and economic exposure at the outset of a lawsuit as well as during the progression of the case to help quantify, qualify and mitigate such risks. Our team partners with health care leadership teams, in-house counsel, insurers and other parties to develop strategies that align with business objectives and economically resolve disputes.

Health Care Regulatory

Our team works tirelessly to help clients confidently navigate the complexities and fast-changing regulations, rules and mandates across federal, state and local levels. We counsel clients on legislative strategy and interpretation of changes, and we advise them on how to properly implement and comply with requirements. We proactively monitor proposed or anticipated legislative initiatives that may impact our clients so they can make their voices heard and protect their interests. We also represent hospitals and health care providers in navigating the Stark law and Anti-kickback statutes, and how to detect, prevent and mitigate Fraud, Waste and Abuse to avoid running afoul of the False Claims Act, or Medicare/Medicaid fraud claims. Additionally, we counsel pre-emptively and responsively on peer review, licensing, certification and accreditation matters, as well as disciplinary actions and best practices through Compliance training. We also help clients understand the prudence of when to agree to Corporate Integrity Agreements, and how to maximize the value of Advisory Opinions and the role of a Legal Safe Harbor. We have advised multiple clients on evaluating the appropriate response to Federal Trade Commission Investigations for allegations of Inadequate Data Security Protocols that might expose clients to Unfair Trade Practices claims or HIPAA violations.

Health Care Transactions

Our team supports health systems, academic medical centers, hospitals, physician groups, ambulatory surgical centers, laboratories, and other health care businesses on day-to-day corporate transactions. We counsel on, draft and negotiate a myriad of healthcare transactions, including: Electronic Health Records (EHR) implementation agreements (including Software-as-a-Service – SaaS arrangements), assist clients with entity formation, partnership agreements, joint operating agreements, mergers and acquisitions, joint ventures, managed care contracts, employment contracts, clinical affiliation and clinical co-management agreements, strategic planning relating to Certificate of Need (CON) or Change of Ownership (CHOW) documents, obtaining tax-exempt status, reimbursement documentation support, ensuring transactions do not run afoul of private inurement or beneficiary inducement limitations and documenting compliance with the same. We also counsel and lead clients on dissolution of partnership, capital and equity structuring, buyouts, non-compete contracts, other restrictive covenants and other business entity changes.

Related Industries

Health Care

Already among the most regulated industries, and now grappling with the uncertainty regarding the impact of the Patient Protection and Affordable Care Act and other reforms, the health care industry and those doing business with the sector rely on HBS to advise on and effectively resolve their business, legal, and regulatory challenges. We advise on all aspects of our clients’ healthcare related businesses from structuring, employment issues, office management, corporate governance and transactional matters to malpractice issues, patient privacy, records retention and data protection.


Insurance

From appraisals, coverage, claims and adjusting issues to drafting and review of insurance policy, regulatory compliance advice and dispute resolution, HBS assists insurance industry clients with resolving the many challenges they face.

In addition to managing risk and defending liability claims, we regularly advise clients on the full range of insurance products, services, and coverages, including general liability, automotive, life, property and casualty, director and officers’ liability, professional malpractice, errors & omissions coverage, business interruption and environmental, cyber-risk and other specialty coverages and exclusions.

Our lawyers represent clients in courts of all levels throughout the United States, litigating class actions, multiparty and multi-district cases as well as individual lawsuits involving virtually every type of claim, coverage, fraud and bad faith action. We handle regulatory investigations and enforcement actions and are experienced with all forms of alternative dispute resolution. Active insurance coverage attorneys in the international insurance markets, we also help domestic clients gain access to the overseas market and assist foreign insurers in managing their domestic litigation.

As industry leaders, HBS Insurance Coverage lawyers have been recognized as Super Lawyers and Rising Stars in the field of insurance. Team members regularly write and lecture on insurance and property ISU issues, and are active members in insurance industry groups. As a value-added, we offer clients employee training to help their staff understand the laws and regulatory requirements impacting their industry and strategies to minimize risk exposure.


Government & Municipalities

With a team of former and current government leaders , and those actively involved in various areas of government, HBS offers comprehensive representation and advice to those in government, including states, counties, cities, non-profits and other related industries.

Our team members are regarded as among the most influential leaders in the state of Georgia and are repeatedly recognized for their work on behalf of clients in the government arena. Regularly interacting with legislative leaders concerning client needs, we maintain close working relationships with elected officials, appointed officials, and agency staff, enhancing our ability to provide expertise and counsel. Leveraging our connections, regulatory know-how and legal experience, we work with local, county and state government officials to craft good policy and address our clients’ legislative, regulatory and legal concerns.

HBS attorneys assist clients with the full range of local, county and state government affairs, regulatory matters, lobbying efforts, and political and campaign finance issues. Understanding the regulatory framework which affects our clients’ business operations, we are particularly adept at helping related regulated industries such as utilities, energy and trade associations, telecommunication companies, health care, insurance, local governments, and nonprofit organizations with compliance matters.