C. Mitchell Goldman

C. Mitchell Goldman

C. Mitchell Goldman focuses his practice on the corporate aspects of healthcare delivery, with an emphasis on structuring corporate transactions between providers, advising clients on the impact of government regulation, creating strategies to improve reimbursement and developing startup healthcare related business opportunities.

He is the founder of GLS Associates, Inc., a management consulting firm that served healthcare providers for 20 years, a former vice-president of Managed Care Strategies, Inc., and a former legislative assistant in the office of former Senator Walter F. Mondale.

A frequent lecturer on the medical malpractice insurance crisis and new business opportunities for hospitals and physicians, he is a member of the American Health Lawyers Association, the American Hospital Association, the Pennsylvania Society of Hospital Attorneys and the Philadelphia and American bar associations. Mr. Goldman is a 1980 graduate of Temple University School of Law, a graduate of the University of Pennsylvania, Wharton Graduate Health Care Administration Program, where he received his M.B.A., and a graduate of Bowdoin College.

Representative Matters

· Hospital General Counsel: Have served as counsel to a 350 bed community hospital, reporting to the CEO and the board. Handling all issues associated medical staff governance and credentialing, hospital physician joint ventures; negotiating the purchase of medical malpractice insurance and captive alternatives for hospital and independent medical staff, regulatory counseling on HIPAA, Medicare and Medicaid fraud and abuse concerns and Certificate of Need laws. Negotiated the purchase of primary care physician practices, chief advisor on redesigning hospital business relationships with certain physician groups. Advised hospital and board on antitrust strategy concerning new ventures.

· Hospital Sale: Representing a 350-bed nonprofit hospital in the sale to a for-profit system and the creation of a community foundation with assets in excess of $50 million.

· Leading Edge Medical Malpractice Insurance Company: Founder of a medical malpractice insurance company, an affiliate of Duane Morris, now licensed in three states with more than 1500 physician insureds. This is a new model of insurance that brings the hospitals, the physicians and the insurers together to reduce the number and the cost of claims as well as to improve patient safety.

· Reimbursement Negotiations: For a large multi-hospital emergency medicine group, challenged the payment practices of a major insurer where the client has lost more than three million dollars. Through an innovative legal interpretation of the insurers payment practices and the filing of a lawsuit, we obtained a settlement valued at more than 2.5 million dollars in cash and increased reimbursement.

· Ambulatory Surgery: Represented the three physician owners in the development of an ambulatory surgery center. Obtained all the approvals, structured the business transaction and remained as reimbursement and regulatory counsel for the center for the past 15 years. The center is a six room facility which has recently been valued at more than 20 million dollars.

· Anesthesia Purchasing Group: Structured a 300 person anesthesia buying group and represented the group as general counsel. We developed an innovative malpractice insurance product which involved some risk sharing and in the end has resulted in significant savings over a four year period.

· HIPAA Hospital Personnel Training: For a major state hospital association, designed the training materials and conducted more than 15 live and/or teleconferences for more than 1000 hospital employees. The training modules included general training on the key aspects of HIPAA compliance and detailed modules on business associate agreements, minimum disclosure rule, HIPAA preemption and special training programs for physicians.

· Special Counsel to the Bankruptcy Court: Appointed by the Court as an expert to evaluate Medicare claims for a bankrupt healthcare provider. Designed a sampling procedure and negotiated a settlement with the Medicare program and the U.S. Attorney's office to collect more than 4 million dollars for the unsecured creditors.

· Medicare Receivables Financing: For a major Catholic healthcare provider, developed a solution to financing the accounts receivable of one of its hospitals that was closing its doors. The client's general counsel had indicated that this transaction could not be done under the Medicare law. The final solution to the client's problem resulted in receiving approximately 3 million dollars by selling their receivables under our recommended process.

Professional Activities

· A frequent author and lecturer on matters involving legal and insurance issues in managed care contracting and with the American Hospital Association Managed Care Forum, The Institute for Behavioral Health, the Hospital Association of Pennsylvania, and the Healthcare Financial Management Association. He has also lectured on insurance fraud and abuse for the American Hospital Association's Society for Strategic Planning and Hospital Marketing.

· Adjunct Professor, Health Care Finance, Widener University School of Law

· Founder and Corporate Secretary, Corporate Alliance For Drug Education, 1986-present; Vice President, 1999

· Outside Director, Penn Treaty American Corporation, 1987-1999

· American Bar Association

· Legislative Audit Committee, Pennsylvania Legislature, 1990-1992

· Philadelphia Bar Association

· American Health Lawyers Association

· American Hospital Association

· Pennsylvania Society of Healthcare Attorneys

Experience

· Duane Morris LLP
- Partner, 1999-present

· Managed Care Strategies, Inc., Philadelphia, Pennsylvania
- Vice President, 1988-present

· GLS Associates, Inc., Philadelphia, Pennsylvania
- Vice President and Shareholder, 1975-1995

· Goldman & Marshall, P.C., Philadelphia, Pennsylvania
- President, 1981-1999

Selected Publications

· Author, "A Public Option Compromise For Insurance Competition," Law 360, September 30, 2009

· Co-author, "Adopting Electronic Medical Records: What Do the New Federal Incentives Mean to Your Individual Physician Practice?, The Journal of Medical Practice Management, July/August 2009

· Co-author, "A Series of Unfortunate Events: Is This the End of the Physician/Hospital Joint Venture?" Health Lawyer News, February 2009

· Co-author, "The Recession is Real: Ten Steps a Hospital CEO Should Consider Taking Now," Modern Healthcare, April 2008

· Co-author, "The Malpractice Insurance and Quality Conundrum," published sixth in a series of Managed Healthcare Insights, based on the Wharton Health Care Management Alumni Association conference, Philadelphia, Pennsylvania, October 2002

· Author, "Why Physician Groups Are Self-Insuring," published by Journal of Medical Practice Management, July/August 2006

· Author, "Doctors Revive Risk Retention Groups," published by New Jersey Law Journal, July 17, 2007

Selected Speaking Engagements

· Speaker, "Physician/Hospital Joint Ventures: What Next for Physician Entrepreneurs," American Bar Association Health Law Section 10th Annual Conference on Emerging Issues in Health Law, February 19, 2009

· Speaker, "Hospital Syndications: The Opportunities and Pitfalls," ABA Health Law Section 8th Annual Conference on Emerging Issues in Healthcare Law 2007, Orlando, Florida, February 21-23, 2007

· Co-presenter, "New Insurance Options for Managing Hospital and Physician Risk," New Jersey Hospital Association, January 26, 2006

· Co-presenter, "The HIPAA (Health Insurance Portability and Accountability Act) Final Regulations: Where to Start?" Florida Hospital Association, Fort Lauderdale, FL, April 19, 2001

· Presenter, "The Federal HIPAA Administrative Simplification Provisions, Affecting the Transmission and Disclosure of Electronic Health Information," Florida Hospital Association, November 20, 2000