Mills Fleming chairs HunterMaclean's health care practice group. Mills is a past president of the Georgia Academy of Healthcare Attorneys and a member of the American Health Lawyers Association. His practice concentrates on the general representation of health care systems, specialized regulatory support to health care entities and specialized projects involving compliance planning, qui tam/FCA investigations, health care industry restructuring, tax-exempt entities and intermediate sanctions, reimbursement, fraud and abuse, managed care, and health care policy. He also assists clients with compliance self-assessments and remedial actions, Stark Law compliance assessments, and the development of multi-provider joint ventures.
Mills is included in the most recent editions of The Best Lawyers in America. He writes and speaks frequently on health care law issues and is co-editor of the Georgia Hospital Association's Hospital Law Manual, fifth edition (2006). He also wrote an article on the final HIPAA privacy rules for the American Bar Association's American Law Institute and has presented on the Sarbanes-Oxley Act at the Georgia Academy of Healthcare Attorneys' annual meeting.
Mills' practice also focuses on immigration and nationality law; he began practicing in this area in 1990. His practice includes extensive visa work, handling both temporary and permanent visa cases and J-1 waivers, as well as advice regarding compliance with the I-9, discrimination, and document abuse provisions of the Immigration Reform and Control Act of 1986. Mills is a member of the American Immigration Lawyers Association, the ABA-affiliated association for attorneys practicing immigration law. He is a frequent lecturer and presenter on immigration topics, and he advises employers regarding best practices in employment-related topics.
Mills graduated from the University of Florida with a B.A. in 1986 and a J.D. in 1989. He began his legal career at HunterMaclean, served for three years as general counsel with a large hospital system, and returned to HunterMaclean in 1995. He is admitted to practice in the U.S. District Court for the Southern District of Georgia and the State of Georgia.
•Represented major health care system in corporate restructuring of large multi-specialty physician group practice from for-profit to tax-exempt status.
•Negotiated joint pricing collaborative between two major health care systems and obtained USDOJ approval for the transaction.
•Negotiated affiliation agreement between major health care system and a university-based medical school.
•Corporate reorganization of major health care system and obtained IRS private letter ruling for same.
•Negotiated the sale of a hospital-based outpatient surgery center to a hospital-physician joint venture ASC. Obtained first-ever letter of non-reviewability for this type of transaction from the Georgia Department of Community Health.
•Served as health care system counsel for several $150+ million tax-exempt bond financings and refinancings.
•Negotiated Shared Services Agreement between major health system and multi-state health care provider.
•Negotiated sale of hospital-based air and ground ambulance service.
•Negotiated waiver of major health care system's default of its tax-exempt bond debt.
•Served as health care system counsel for Community Needs Assessment and IRC Section 501(r)compliance.
•Represented nonprofit hospital in negotiations with county government and county hospital authority for the provision of indigent care.
•Negotiated telemedicine contracts between major health system and numerous regional hospitals.
•Represented major health care system in management agreement negotiations.
•Advise nonprofit hospital boards of directors and management on governance requirements, corporate bylaws, and compliance.
•Served as hospital counsel for $50 million taxable and tax-exempt financing for major health system's electronic medical record hardware and software purchase.
•Hospital counsel for public access requests under Georgia's Open Meetings and Open Records Act.
•Represented major health care system in obtaining a joint venture ownership interest in a neurosurgery ASC.
•Represented major health care system in the sale of its inpatient rehabilitation service line to for-profit joint venture with a national health care provider.
•Represented major health care system in negotiating multi-million dollar line of credit arrangement.
•Obtained tax-exempt status and IRS Private Letter Ruling for hospital-based multi-specialty physician group practice.
•Negotiated transition of hospital-based children's hospital into a tax-exempt joint venture owned by major health care system and multi-state health care provider.
•Negotiated sale of hospital-based urgent care operation to joint venture owned by health care system and regional health care provider.
•Represented nonprofit hospital in intercompany service agreement negotiations.
Hospital Physician Contracting
•Negotiated hundreds of hospital-physician employment agreements.
•Negotiated hundreds of independent contractor professional service and medical director agreements for Radiology, Gastroenterology, Anesthesiology, Orthopedic Trauma, Neurology, Neurosurgery, Cardiology, Radiation Oncology, Emergency, and Vascular Surgery Physicians.
•Served as hospital counsel for employment of and immigration (e.g. J-1 waivers, H-1B and O-1 visas, and permanent residency) filings for foreign national physicians.
•Provided Stark law, Anti-Kickback Statute, and False Claims Act advice for health care systems.
•Advised health systems on compliance programs, OIG work plans, and internal audits.
•Advised health care systems on establishment of tax-exempt bond compliance programs under IRS guidelines.
•Represented major health care system in criminal and civil fraud and abuse and tax fraud investigation by the USDOJ alleging violations of the Stark law and the Anti-Kickback Statute and the use of the employment exception.
•Represented health care executive in USDOJ investigation of False Claims Act violations.
•Represented major health care system in USDOJ investigation of Stark law, Anti-Kickback Statute, and False Claims Act violations relating to physician compensation and fair market value and commercial reasonableness issues.
•Represented nonprofit hospital in 340B Pharmacy Program audit.
Creative Financing: Firm Secures Multi-Million New Markets Tax Credit for Health System
Firm partners Ben Hartman and Adam Kirk spearheaded a landmark multi-million-dollar New Markets Tax Credit Program deal for Southeast Georgia Health System, one of HunterMaclean's clients. The deal will lead to significant savings for the Health System's new Medical Office Building and Community Care Center.
The Architecture of Business: Attorneys Guide Telfair Through Expansion
HunterMaclean helped lay the groundwork for the Telfair Museum of Art to build the new Jepson Center, a sleek, contemporary building on Telfair Square in downtown Savannah. The Jepson successfully bridges the city's historic architecture with its vibrant future, serving as a centerpiece of Savannah's cultural community.
Best Lawyers in America: Health Care Law, Immigration Law; 2003-2015
Best Lawyers is the oldest and most highly-respected peer review guide to the legal profession worldwide. A listing in Best Lawyers is widely regarded by both clients and legal professionals as a significant honor, conferred on a lawyer by his or her peers.
Chambers USA, America's Leading Lawyers for Business: Health Care Law, 2014
Chambers USA ranks the leading firms and lawyers in an extensive range of practice areas throughout America.
Georgia Super Lawyers: Health Care Law, 2006-2014
Super Lawyers is a rating service of outstanding lawyers from more than 70 practice areas who have attained a high-degree of peer recognition and professional achievement. The selection process is multi-phased and includes independent research, peer nominations and peer evaluations.
Georgia Trend Magazine Legal Elite: 2012
Georgia Trend Magazine's annual listing of Georgia's top attorneys, selected by their peers. The list includes eight practice areas: business law; personal injury litigation; criminal law; labor and employment; taxes, estates and trusts; bankruptcy and creditors' rights; family law; and general practice/trial law.
Martindale-Hubbell: AV Rated
The Martindale-Hubbell PEER REVIEW RATINGS are an objective indicator of a lawyer's high ethical standards and professional ability, generated from evaluations of lawyers by other members of the bar and the judiciary in the United States and Canada.
Presentations & Publications
Mills Fleming Op Ed: A 275-year-old solution to saving Savannah's youth
Mills Fleming responds to Jan Skutch's article on saving Savannah's youth with Bethesda success story.
New Health Care Exchanges to Impact Employers, Hospitals
HunterMaclean partner Mills Fleming explores the complexities of health care exchanges and their potential impact on employers as well as medical providers.
New Government Scrutiny Demands New Strategies for Health Care Clients
Chapter by T. Mills Fleming published in 2011 in Health Care Law Enforcement and Compliance.
Georgia Immigration Reform Effective July 1
By T. Mills Fleming, published on June 1, 2011, in Business in Savannah.
When Georgia's Governor Nathan Deal signed House Bill 87 into law earlier this month, he helped shape the ongoing national debate about immigration reform and affected the way Georgia employers can be prosecuted for knowingly hiring undocumented residents.
The new legislation officially takes effect on July 1 at which time Georgia will become the third state in the U.S. to pass its own immigration reform measures. Although immigration enforcement is typically the responsibility of federal authorities, many states argue that the federal government has not done enough to secure our nation's borders and to protect America from the financial burden of a seemingly endless sea of illegal immigration. Alabama and South Carolina are considering similar immigration bills that could pass later this year.
Immigration Officials Increase I-9 Audits and Enforcement on Employers
By T. Mills Fleming, published on February 24, 2010, in Business in Savannah.
Immigration law may not be at the forefront of the political landscape, but that doesn't mean you should be lulled into a false sense of security.
On the contrary, immigration officials lately have begun conducting more Form I-9 audits and have refocused their prosecution on employers rather than illegal immigrants. Employers who do not carefully check their employees' identity and eligibility status could face up to 10 years in prison or a fine of up to $1,100 per violation because a false statement on an I-9 form is considered felony perjury.
Hospital Medical Records
By T. Mills Fleming.
Health System Restructuring, Private Letter Ruling
By T. Mills Fleming, published on December 20, 2001, in PLR 200211051, (12/20/01).
This is in response to your ruling request concerning a proposed hospital reorganization and its effect on the tax
exempt status under section 501(c)(3) of the Internal Revenue Code, foundation classification under section 509(a) of
the organizations involved, and the applicability of the unrelated trade or business income tax provisions under sections
511 through 514 of the Code.
Physician Compensation/Gain Sharing, Private Letter Ruling
By T. Mills Fleming; unpublished; dated April 30, 1998 .
Undocumented Alien Claims: Finding a Place to Stand
Presented at the ICLE Workers' Compensation Judges Annual Seminar in Jekyll Island, Georgia, on April 2, 2001, by T. Mills Fleming.
The United States' immigration policies have changed dramatically over the last 200 years from being a virtual open door to now being a tightly controlled and highly regulated set of rules and regulations. The first law limiting immigration was the Alien Act of 1798 wherein the president was authorized to expel any alien he deemed dangerous. From that time until the later part of the 19th century, Congress passed very little laws restricting immigrant flow to the U.S.
Beginning in 1875 Congress passed several immigration reform measures beginning with a statute providing for the exclusion of convicts and prostitutes. That law was followed by the Chinese Exclusion Act of 1882 which provided for the exclusion of persons from China - and was not repealed until 1943. Congress passed other laws to exclude cheap foreign labor and in 1888 provided for the deportation of aliens entering in violation of these contract labor laws.
HunterMaclean Attorneys Selected For The Best Lawyers in America 2015
HunterMaclean is pleased to announce that 22 lawyers from the firm were recently selected by their peers for inclusion in The Best Lawyers in America 2015.
HunterMaclean Law Firm Ranked in Chambers USA Guide 2014
HunterMaclean is pleased to announce that it has been ranked in the Chambers USA Guide 2014, an exclusive annual listing of top law firms and lawyers in the U.S. Chambers and Partners is widely considered the authority on lawyer and firm rankings in the legal profession across the world.
Fifteen HunterMaclean Attorneys Honored as 2014 Georgia Super Lawyers and Rising Stars
Atlanta magazine just announced the top attorneys in the state of Georgia, and 15 attorneys at HunterMaclean were named either Georgia Super Lawyers or Rising Stars.
25 HunterMaclean Attorneys Selected for The Best Lawyers in America 2014
HunterMaclean is pleased to announce that 25 lawyers from the firm were recently selected by their peers for inclusion in The Best Lawyers in America 2014.
Health care attorney Mills Fleming speaks to WTOC about the Supreme Court DOMA decision
Health care attorney Mills Fleming spoke with WTOC about the impact of the Supreme Court ruling on the Defense of Marriage Act (DOMA).
Attorney Mills Fleming Elected Board Chairman for Bethesda Academy
HunterMaclean partner Mills Fleming was recently elected chairman of the board for the Bethesda Academy. Mills previously served as vice chair of the board. Bethesda Academy is dedicated to transforming the lives of young men.
HunterMaclean Attorneys Honored as Georgia Super Lawyers, Rising Stars
Nine HunterMaclean attorneys were recently recognized as Georgia Super Lawyers. Two of the firm's partners were also named Rising Stars.
Record Number of HunterMaclean Attorneys Selected for Georgia Trend's 2012 “Legal Elite” Issue
Georgia Trend honored 14 HunterMaclean attorneys in the magazine's annual “Legal Elite” issue, which recognizes the top attorneys in the state of Georgia.
28 HunterMaclean Attorneys Among 'Best'
HunterMaclean, a business law firm with offices in Savannah and Brunswick, has announced that 28 lawyers from the firm were selected for inclusion in The Best Lawyers in America 2013.
Health Care Shakeout Begins
Savannah Morning News turns to health care attorney Mills Fleming for expert opinion on how the landmark Supreme Court ruling will affect Georgians.
10 HunterMaclean Attorneys Honored as Georgia Super Lawyers
Ten HunterMaclean attorneys have been selected as 2012 Georgia Super Lawyers. Atlanta Magazine will honor the firm's attorneys in the March 2012 issue.
The prestigious Georgia Super Lawyer honor is awarded annually to the top five percent of attorneys in the state, as chosen by their peers and through independent research.
Record Number of HunterMaclean Attorneys Selected for The Best Lawyers in America for 2012
HunterMaclean, a leading business law firm with offices in Savannah and Brunswick, is pleased to announce that Best Lawyers in America, the oldest and most respected peer-review publication in the legal profession, recently honored a record 23 HunterMaclean attorneys by including them on this prestigious list of leading lawyers.
“We are delighted to have a record number of attorneys from our firm featured on this year's Best Lawyers in America list,” said Frank S. Macgill, HunterMaclean's managing partner. “This honor reflects hard work on the part of the firm's partners and associates.”
HunterMaclean Partner T. Mills Fleming Publishes Chapter in Health Care Law Enforcement and Compliance, Co-Authors Chapter in The Georgia Hospital Law Manual
HunterMaclean, a leading business law firm with offices in Savannah and Brunswick, is pleased to announce that partner T. Mills Fleming, chair of the firm's Health Care Practice Group, recently authored a chapter in Health Care Law Enforcement and Compliance: Leading Lawyers on Understanding Recent Trends in Health Care Enforcement, Updating Compliance Programs and Developing Client Strategies.
Fleming contributed a chapter titled “New Government Scrutiny Demands New Strategies for Health Care Clients,” which explores the impact of recent health care laws and regulations on hospitals, health care facilities and medical practitioners.
10 HunterMaclean Attorneys Honored as Georgia Super Lawyers for 2011
Atlanta Magazine recently recognized 10 HunterMaclean attorneys as Georgia Super Lawyers in its March 2011 issue.
The prestigious Georgia Super Lawyers honor is given annually to the top five percent of attorneys in the state, as chosen by their peers and through independent research by Law & Politics, a magazine which published the first list of Super Lawyers 20 years ago.
Record Number of HunterMaclean Attorneys Selected for The Best Lawyers in America for 2011
The Best Lawyers in America for 2011, a confidential peer-review survey, recently honored a record 28 HunterMaclean attorneys by including them on this prestigious list of leading lawyers. Last year, 20 attorneys at HunterMaclean earned this top honor.
“We're delighted to have a record number of attorneys from our firm featured on this year's Best Lawyers in America list,” said Frank S. Macgill, HunterMaclean's managing partner. “Our attorneys work hard for our clients and it shows.”
Nine HunterMaclean Attorneys Honored as Georgia Super Lawyers for 2010
Atlanta Magazine recently named nine HunterMaclean attorneys as Georgia Super Lawyers in its March 2010 issue. The prestigious Georgia Super Lawyershonor is given annually to the top five percent of attorneys in the state, as chosen by their peers and through independent research by Law & Politics, a magazine which published the first list of Super Lawyers 19 years ago.
Mills Fleming Obtains Favorable Healthcare Antitrust Letter Ruling from USDOJ
Mills Fleming, chair of HunterMaclean's healthcare practice group, obtained a favorable letter ruling from the U.S. Department of Justice's Antitrust Division relating to a unique hospital joint purchasing agreement.
The USDOJ's ruling, released publically on September 4, said that the Department “will not challenge a proposal by Memorial Health, Inc. and St. Joseph's/Candler Health System to enter a exclusive joint purchasing agreement with respect to the purchase of certain medical and surgical supplies.”
Record Number of HunterMaclean Attorneys Selected for The Best Lawyers in America for 2010
The Best Lawyers in America for 2010, a confidential peer-review survey, recently honored a record 20 HunterMaclean attorneys by including them on this prestigious list of leading lawyers. Last year, 18 attorneys at HunterMaclean earned this top honor.
“We are delighted to have a record number of attorneys from our firm featured on this year's Best Lawyers in America list,” said John M. Tatum, HunterMaclean's managing partner. “Our attorneys work hard for our clients and it shows.”
11 HunterMaclean Attorneys named 2009 Georgia Super Lawyers
Atlanta Magazine recently named 11 HunterMaclean attorneys as Georgia Super Lawyers in its March 2009 issue. The prestigious Georgia Super Lawyers honor is given annually to the top five percent of attorneys in the state, as chosen by their peers and through independent research by Law & Politics, a magazine which published the first list of Super Lawyers 18 years ago.
Eighteen HunterMaclean Attorneys Named 2009 Best Lawyers in America
Bethesda Academy: Board of Directors, Chair; Endowment Committee, Member
Telfair Museum of Art: Board of Directors, Immediate Past Chair
Memorial Health University Medical Center Foundation: Board of Directors, Past Chair
Lucas Theatre for the Arts: Board of Directors, Past President
Savannah Music Festival: Board of Directors, Past Member
Court Appointed Special Advocates: Board of Directors, Past Member
Rape Crisis Center: Board of Directors, Past Member
Savannah Country Day School: Annual Fund Chair
Savannah Voice Festival: Board of Directors, Member
Savannah Philharmonic: Advisory Board