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Services Available
Representative Engagements
Stark and Anti-Kickback Regulations - Our attorneys regularly advise on Stark and anti-kickback issues and have developed unique ways for physicians to share in ancillary revenue in compliance with federal and state regulations.
Multimillion-Dollar Settlement of Disputed Claims by Physicians and Hospitals - Using an innovative approach and a proprietary audit tool, our lawyers brought a lawsuit that resulted in a speedy settlement and a multimillion-dollar payment to more than 400 physicians. The lawsuit also served as a mechanism to audit future payment patterns and to ensure that the client will not have to file similar claims in the future.
Innovative Approaches to Hospital Reimbursement - As a leader in representing hospitals in their disputes with payors to obtain adequate payment for their services, our lawyers brought a lawsuit on behalf of a community hospital under several unique theories attacking the insufficient payments of a local Blue Cross plan. The case gained national attention.
Self Insurance Options for Hospitals - Utilizing its understanding of malpractice insurance, Duane Morris has designed self-insurance trusts and off-shore captive insurers to offer insurance coverage to hospitals unable to find affordable malpractice coverage.
For a complete list of representative services and engagements, contact any Duane Morris office and ask to speak with a healthcare lawyer.
tax and corporate lawyers in our healthcare group have represented hospitals in transactions of all types. These include hospital restructurings and expansions, conversions, acquisitions, development of hospital-physician joint ventures, ambulatory surgery, radiation oncology, cardiology and lithotripsy centers.
We represent hospital clients in administrative hearings and litigation involving managed care, employment and commercial disputes, reimbursement matters, medical staff relationships, insurance and liability questions of all kinds. We understand hospital finance, cost accounting and reimbursement issues and have developed creative solutions to difficult problems.
Our lawyers represent the Hospital Association of Pennsylvania and work closely with hospital associations in other states. We also work with a number of hospitals in academic medical centers and are well versed in the issues faced by academic hospitals and faculty practice plans. We have represented hospitals in connection with research studies and clinical trials. Attorneys and medical professionals, employed by a Duane Morris subsidiary, work with hospitals to provide innovative solutions to problems related to billing, coding and denial of claims.
Services for Post-Acute Care Providers
Business Issues: From development of new facilities to general operational matters, post-acute care providers need legal assistance and counsel in nearly every aspect of their business. Our practice in this area is designed to meet these providers' specific needs and relies on our significant involvement and understanding of their industry. Our approach to representation of post-acute care providers involves a coordinated effort among lawyers with experience in relevant subject matters, including health law, corporate law, tax-exempt law, employment law, information technology law, real estate law and litigation.
Duane Morris Capabilities: Our post-acute care practice is both transactional and operational. We represent virtually all segments of the post-acute care industry, including skilled nursing and rehabilitation facilities, assisted living and seniors housing communities, home care agencies and hospices. Our clients range from the smallest single facility providers to some of the largest post-acute care providers in the country. Our attorneys have a broad range of experience and knowledge in the post-acute care industry including the following:
- Acquisitions and Sales - including all phases of structuring and negotiating transactions.
- Development of New Facilities - including advising clients in all phases of developing new facilities such as real estate acquisition, zoning matters, financing and regulatory (CON) approvals.
- General Operational Matters - including assisting clients in their general operations: federal/state quality surveys, releases of medical records, compliance with fraud/abuse laws, advance directives for healthcare, patient care issues, vendor disputes, admission and residency agreements and arrangements with vendors, suppliers and independent contractors.
- Reimbursement Matters - including working with clients and their accountants in negotiating Medicare and Medicaid reimbursement issues with federal and state regulators.
- Certificate of Need Issues - including prosecuting licensure applications for post-acute care providers before state CON agencies.
- Employment Law Matters - including advising providers on employment matters such as employment manuals, hiring and termination requirements, wrongful discharge litigation and discrimination laws.
We also have extensive experience with government investigations and compliance programs. Our representations include encounters with state Medicaid Fraud Control Units as well as the U.S. Department of Health & Human Services, Office of Inspector General and the U.S. Department of Justice. Our work includes counseling clients in connection with investigations of their ancillary service providers and of providers themselves.
For More Information
For more information, please contact Donald R. Auten, David E. Loder or any of the practice members referenced in the Attorney Listing.
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