Counsel on commercial arrangements, business operations and regulatory matters

The implementation of the Affordable Care Act has resulted in increased spending for hospitals, physician practices, senior living organizations, life sciences companies, health care information vendors, ambulatory surgery centers, certain payors and generally all participants in the health care industry. Regardless of size or structure, health care businesses must continue to 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 –remain vigilant with enforcement activity.  Ongoing compliance efforts are 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 will remain prevalent throughout the health care delivery system.

Saul Ewing’s health care industry clients confront these and many other challenges and the firm’s attorneys are there to represent them in corporate, transactional, regulatory, compliance, labor and employment, tax and employee benefits, energy and environmental, litigation and bankruptcy matters. Their work includes assisting health care providers in developing and implementing various sophisticated forms of commercial arrangements, including accountable care type organizations that focus on population health initiatives, mergers, acquisitions, strategic engagements, and new business formations. They also provide advice and counsel on day-to-day business operations, including management and governance, contract drafting and negotiation, physician and staff employment issues, and tax matters. The team’s regulatory work includes compliance with HIPAA and federal and state anti-kickback and physician self-referral statutes and regulations, advice on licensing, accreditation and survey-related matters,  as well as Affordable Care Act compliance in connection with employee benefits. Saul Ewing attorneys conduct risk assessments to help health care businesses identify where they may need to make operational changes with the aim of preventing fraud and abuse, data breaches, and activities to ensure compliance with an organization’s tax-exempt status.

Saul Ewing’s health care team has experience advising:

  • Academic medical centers and community hospitals and long term care hospitals
  • Ambulatory surgery centers and other freestanding facilities
  • Physician and dental practices, and individual licensed practitioners
  • Participants in the Medicare Shared Savings Program, commercial “accountable care organizations” and other innovative health care delivery organizations
  • Community health centers and federally qualified health centers
  • Medical specialty boards 
  • Medical societies
  • Colleges and universities
  • Device manufacturers in FDA related activities 
  • Provider joint ventures 
  • Senior living organizations (e.g., continuing care retirement communities, nursing homes and assisted living facilities)
  • Health care software and technology companies
  • Infusion therapy providers
  • Physical therapy providers
  • Durable medical equipment (DME) companies
  • Health care consulting firms
  • Medical billing companies
  • Pharmacies
  • Home health care companies

The activities of the firm’s health care lawyers comprise the following general subjects:

  • Corporate/Transactional
  • Regulatory
  • Litigation/Counseling
  • IT Contracting
  • Real Estate
  • Bonds/Financing
Saul Ewing understands our company and recognizes our importance as a client. Even the small jobs are handled with a high level of service.

Experience

Saul Ewing attorneys have represented notable clients in these select matters:

  • Represented a Pennsylvania county in the sale of its nursing home and associated real estate. Responsible for the legal issues surrounding the sale of the assets including: real estate and environmental issues; financing; licensure transfer; and regulatory compliance.
  • Ongoing representation of a major university and affiliated health system for sophisticated health care information technology agreements.
  • Assisted a state medical society with the creation and implementation of a commercial accountable care organization with a large commercial insurance payor.
  • Counsel to four large academic medical centers with respect to their involvement in a large regional health information exchange.
  • Served as lead counsel in a class action effort against a well-known regional company relating to Medicare reimbursement benefiting some 300 ambulance providers in the 29-county Western Pennsylvania region.
  • Represented a multi-hospital health system in the formation and implementation of a completely new hospital. Advised the board of directors and the administration regarding the nonprofit corporate, charitable, tax and health care regulatory aspects of the creation of the new hospital.
  • Represented a 70-member, for-profit, multispecialty physician practice in its sale to a large, publicly traded health system. Handled the legal aspects of the transaction including negotiating and drafting the letter of intent, agreement of sale and the model employment agreement under which all the physicians would be employed following the sale.
  • Ongoing representation as external counsel to the leading U.S. provider of specialty home infusion services in the national expansion of its business operations, including counseling on licensure, certificate of need and regulatory compliance matters.
  • Negotiated and documented the acquisition of complex technology systems for electronic health records management; admission, discharge, and transfer (ADT); CPT coding, billing and reimbursement; electronic ICU facilities; radiation therapy and radiosurgery equipment; care management; patient flow management and bed tracking; medical records scanning and imaging; pharmacy and medication management; and patient and fetal monitoring.
  • Assisted a non-profit health network in the formation, structuring and implementation of a community-wide, hybrid health information exchange, including providing counsel on compliance with federal and state anti-kickback and physician self-referral statutes, privacy and security laws, including HIPAA, HITECH and protection of certain sensitive categories of information, and drafting required agreements and policies.
  • Serve as outside general counsel to a large northeastern urology practice. Regularly advise on contractual, personnel, third party affiliations, insurance, compliance, regulatory and labor matters.
  • Obtained “declination” from U.S. Attorney of both criminal and civil fraud charges against a health care practice alleged to have created fatal risk of infection by misusing medical devices during surgical procedures. Conducted an emergency internal assessment, counseled the practice on remedial and disciplinary steps, and helped the client self-disclose to the State Medical Licensing Board. Neither the State Medical Licensing Board nor the Department of Justice took action against the medical practice.
  • Assisted a large regional hospital system with its separation into two regional health systems including the separation of the systems’ combined debt.
  • Represented a major academic medical center in the purchase of an urban community hospital. Negotiated and drafted the letter of intent and the asset purchase agreement and obtained federal, state and local approvals; provided the antitrust analysis (and preparation of the HSR application); and created a new nonprofit corporate entity to acquire the assets of the community hospital; and obtained a determination that the new corporation was exempt under section 501(c)(3).
  • Engaged by a large multi-hospital health system in its acquisition of a community hospital in a neighboring state a few miles from one of its own Pennsylvania campuses. Handled issues related to the drafting, negotiating and implementation of the letter of intent, extensive due diligence (including CMS payment issues), and issues involving corporate governance, public finance, real estate, environmental compliance, charitable assets, corporate reorganization, antitrust (including preparation of its HSR application) and contract assignment. Prepared the definitive agreement, ancillary documents and corporate resolutions.
  • Counseled a Pennsylvania university regarding the advantages and disadvantages of continuing to maintain a legal and practical separation between the university and its college of medicine.
  • Assisted numerous hospitals in joint ventures involving physicians, including the development of ASCs, medical office buildings, wellness centers and various types of outpatient facilities.
  • Represented a large state university with its HIPAA/privacy compliance assessment and white paper.
  • Represented a university in university-wide HIPAA and privacy compliancy review. Assessed which health care components of the university were covered by HIPAA, and drafted and implemented policies and procedures.

News

News

Nov 21 2016
Alerts & newsletters
2016-11-21
Apr 27 2017
Alerts & newsletters
2017-04-27
Aug 22 2016
Alerts & newsletters
2016-08-22
Apr 17 2017
Alerts & newsletters
2017-04-17
Jul 18 2016
Alerts & newsletters
2016-07-18
Oct 17 2016
Alerts & newsletters
2016-10-17
Jul 6 2016
Alerts & newsletters
2016-07-06
Feb 21 2017
Alerts & newsletters
2017-02-21
Jul 13 2016
Alerts & newsletters
2016-07-13

Recognition

The group includes attorneys who have been named to the following lists:

  • Chambers USA

    Chambers and Partners uses a team of more than 140 researchers to rank lawyers on the basis of their legal knowledge and experience, their ability, their effectiveness and their client-service.

  • Super Lawyers

    Super Lawyers selects attorneys using a patented multiphase selection process, utilizing 12 indicators of peer recognition and professional achievement.

  • 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.

Trade Groups & Associations
  • American Health Lawyers Association
  • Healthcare Information Management Systems Society
  • Pennsylvania Society of Health Care Attorneys
  • America’s Health Insurance Plans
  • Healthcare Financial Management Association

Contacts

Bruce D. Armon
Karilynn Bayus