The combination of an aging population, ongoing medical advancements, and health care reform brings even more complexity to the already intricate arena of health care law. Foster Swift's team of experienced health law attorneys has been serving the industry long before its current rise in the public eye.
Complementing the experience of our Health Care Practice Group is the unique blend of regulatory, transactional and litigation attorneys, all whom are knowledgeable with the myriad of health care issues. We represent a wide range of entities including:
- Hospitals
- Physician groups
- Home health and hospice providers
- Long-term care and assisted living providers
- Health care systems and networks
- Managed care organizations
- Physical therapy providers
- Pharmacies and durable medical equipment companies
- Integrated delivery systems
- Health information technology companies
- E-health businesses
- Suppliers and trade associations
- Non-profit health care foundations and organizations
With Foster Swift, clients have the benefit of counsel who have a thorough understanding of the clinical and business realities of health care as well as the legal and regulatory requirements.
While acting as either general or special counsel, clients have retained us for assistance in the following areas:
REGULATORY AND REIMBURSEMENT
Clients seek our assistance on a variety of regulatory and reimbursement matters before local, state, and regulatory agencies, including:
- Licensure and certification matters
- Medicare and Medicaid appeals
- Health care insurance provider audits
- Certificate of Need matters
- Third party reimbursement matters; including Blue Cross Blue Shield of Michigan audits
- Anti-Kickback and Stark II matters
- False claims investigations and litigation
- Tax exemption and TBOR II matters
TRANSACTIONS
In this fast-paced health care environment, our attorneys assist clients with the formation, development and management of affiliations, acquisitions, mergers, joint ventures and newly integrated organizations. Depending upon client goals and the complexity of the transaction, our role can be as simple as reviewing documents or as complex as heading up a multi-member transactional team.
FRAUD AND ABUSE MATTERS
Members of the Foster Swift Health Care Group regularly assist clients in structuring transactions to minimize Anti-Kickback, Stark II, and False Claims. Key to our practice is assisting our clients with the development and implementation of effective compliance programs.
MANAGED CARE, INSURANCE, AND EMPLOYEE BENEFITS
With multiple attorneys with decades of experience, health maintenance organizations, insurance companies, self-funded plans and third party administrators seek us out for representation before the Michigan Office of Financial and Insurance Regulation. In addition we regularly provide advice to networks of hospitals and physician providers on contractual matters, regulatory filings, appeals, credentialing and all aspects of litigation that may arise.
CREDENTIALING
Credentialing issues are undoubtedly one of the most stressful matters for any healthcare provider. Our attorneys have extensive experience in successfully:
- Representing clients in appeals regarding practitioner’s privileges with a facility or participation with a third party payor
- Securing redaction of adverse action reports from state and federal health care professional data banks
- Drafting medical staff bylaws, fair hearing procedures, and credentialing plans.
INFORMATION TECHNOLOGY
Minimizing client risk is always our goal as we assist vendors and purchasers address the legal considerations surrounding the acquisition and implementation of information technology systems in health care industry. Our range of expertise includes:
- Formation, financing and governance of business entities
- Development, marketing and distribution arrangements
- Drafting licensing agreements, systems implementation agreements, joint development agreements and outsourcing agreements
- Advising on Internet and new technology issues
- Product liability
- Information Technology clients also rely on our attorneys to negotiate and draft employment and non-compete agreements.
GENERAL COUNSEL
As general counsel to more than 100 health care industry-related clients, many of which have spanned decades, we become involved in matters unique to individual clients needs and operating goals of the organization, such as:
- Risk management issues
- Employment, labor and benefits issues
- Matters involving the privatization of health care facilities
- Agreements and joint ventures with physicians
- Medical records
- Compliance issues
- Utilization review
- Provider policies
- Hospital finance and bond initiatives
HIPAA PRIVACY AND SECURITY RULES
The HIPAA Privacy and Security Rules are a concern of every health care provider, and our attorneys are committed to helping clients avert risk through the implementation of compliant programs as well as on-going training for all staff. In accomplishing this, we have extensive experience in helping health care providers transition their practices to electronic medical records and the Internet. We also advise clients on the day-to-day issues arising from the HIPAA Privacy and Security Rules.
LITIGATION
Foster Swift attorneys are top tier litigators with an impressive track record of handling complex civil litigation on behalf of health care clients such as:
- Successfully arguing before the United States Supreme Court which resulted in increased Medicare reimbursement for family physicians nationally and enhanced hearing rights for providers under Medicare Part B.
- Having on staff the first lawyer in the country to defend a client against the charges asserted by the federal government in a Stark II action.
- Having extensive experience representing providers in Medicare and Blue Cross Blue Shield of Michigan audits and appeals.
Over the years, Foster Swift attorneys have been involved in many important cases before state and federal appellate courts. This includes authoring numerous amicus briefs which have been referenced in many key state and federal appellate court opinions.
Well respected by their peers, more than half the members of this practice area are included in the Health care category of Best Lawyers in America and have AV® Preeminent rating from Martindale Hubbell. Based on the breadth of their skill, Foster Swift Health Care attorneys have been asked for over two decades to provide the “Michigan Health Law Update” at the annual meeting of the Institute of Continuing Legal Education Health Law Institute.
Foster Swift Health Care attorneys are committed to providing excellent legal counsel in an efficient and economical manner to help clients keep pace with the ongoing change.
Foster Swift has been named a Tier 1 firm in Health Care Law in Lansing and Detroit by U.S. News – Best Lawyers® "Best Law Firms" in 2014 and 2016.
REPRESENTATIVE EXPERIENCE
Assisted in Defense of Medical Providers in False Claims Disputes
Collected millions in reimbursement for major medical provider
Helped Create and Organize a Nonprofit HMO
Helped Sparrow Hospital With Bond Refinancing
Jury awards $125,000 to medical provider
Protection of Professional Licenses and Careers of Health Care Providers
University-Employed Physician is Not Liable as a State Actor Under 42 USC 1983 for Treating Prisoner
Licensing Sanctions for Nurse Dismissed
Hospital Purchase of a Surgical Entity
Medicare/Medicaid Exclusions Dismissed
Prevailed in Various Union Arbitrations Within Nursing Homes
Successfully Defended Hospital Client
Sparrow Hospital: Reduced Taxable Income
Criminal Prosecution of Healthcare Provider: Not Guilty Verdict Attained
Medicaid Fraud Prosecution of Healthcare Physician: Not Guilty Verdict
Regulatory Compliance: On-Site Audits
Represented Health Care Providers in Campaign for Safe Disposal of Radioactive Waste
Medicaid Billing
Nursing Home Employees are only Criminally Liable under the Vulnerable Adult Abuse Act for Consciously Ignoring Risk of Harm of an Act or Omission that Results in Harm
Successfully Defended Staff Privilege Decisions of Private Hospitals not "Justiciable"
