Read any
newspaper or listen to any talk show, and it is clear that changes in the
healthcare industry affect the lives of every American. Healthcare expenditures
in the United States are growing exponentially, and the healthcare industry has
become one of the most highly regulated industries in the United States,
subject to complex and intricate federal and state laws, regulations, and
polices. Rapidly changing and evolving healthcare legislation, as well as
increased attention to healthcare on a global basis, presents challenges to
businesses in the healthcare industry. To navigate the maze of healthcare laws
and regulations, businesses require the assistance of experienced,
knowledgeable legal counsel.
With approximately
390 attorneys firmwide and a group of experienced healthcare attorneys,
Jones Walker offers a broad range of legal services to healthcare industry
clients, including transactional matters, litigation, investigations, and
regulatory compliance. Our representative clients include healthcare systems,
hospitals, academic medical centers, pharmaceutical companies, home health
agencies, nursing facilities, teaching universities, health insurers, health
professionals, practices and associations, veterinary hospitals and practices,
and other healthcare entities. We serve as general or special counsel to
healthcare providers. To keep our clients up-to-date on changing regulations
and legislation, we host seminars, send electronic updates through the firm's
E*Lerts and E*Bulletins, and provide in-house training programs for clients, as
requested.
Transactions
Jones
Walker's attorneys bring a wealth of experience in advising healthcare clients
on transactional and organizational matters. From the acquisition of hospitals
and other providers to the formation of new entities for the delivery of
healthcare services, we routinely provide clients with the transactional
experience necessary to meet their wide-ranging needs. Our healthcare attorneys
have guided clients on mergers, acquisitions, divestitures, joint ventures, tax
structure, entity formation, and financing. We have also advised healthcare
entities on organizational issues, such as corporate governance, board
operations, and bylaw preparation and analysis.
Investigations & Litigation
Our firm
has qualified, experienced attorneys who have handled numerous civil and
criminal government healthcare fraud investigations and qui tam
litigation. Jones Walker has represented both health systems and individuals in
matters involving government entities such as Medicaid Fraud Units, the United
States Attorney's Office, and the United States Department of Justice (DOJ). In
the course of those representations, we have negotiated numerous settlement
agreements and corporate integrity agreements with government entities. Our
attorneys are experienced with Stark and Anti-Kickback Laws, the False Claims
Act (FCA), cost reporting requirements, and other relevant regulations. Our
team of healthcare attorneys has also handled investigations involving
quality-of-care issues, such as medically necessary procedures.
Many of
our attorneys assist healthcare clients in both preparing for and responding to
investigations, surveys, audits, and reviews from both federal, state, and
local governmental agencies, such as the Food and Drug Administration (FDA),
Centers for Medicare & Medicaid Services (CMS), and fiscal intermediaries.
We have also represented healthcare entities in the context of bankruptcy
proceedings, appellate proceedings, administrative proceedings, and other
disputes. We also assist clients with antitrust matters, commercial contracts,
denial-of-coverage matters, drug and pharmaceutical issues, medical product or
device liability, medical malpractice and professional liability, medical staff
bylaw disputes, and resident and hospital-based physician issues.
Regulatory, Compliance & Self-Audits
As one of
the most highly regulated industries in the world, the healthcare industry
presents businesses and individuals with an often perplexing and evolving array
of laws and regulations. From providers to suppliers, and from payers to
billers, these laws and regulations can affect even those primarily engaged in
other industries, such as retailers with on-site health clinics or businesses
with self-insured health benefits plans.
Given the
scope and complexity of current healthcare regulations, businesses need
attorneys who understand the dynamics of healthcare compliance. Jones Walker's
attorneys have substantial experience in assuring that our clients meet their
obligations under applicable healthcare laws.
Our
experience includes:
- Physician self-referral laws
(Stark laws)
- Civil monetary penalty laws
regulating patient inducement and other matters
- Anti-kickback laws
- False Claims Act (FCA)
- Medicare Conditions of
Participation, state licensure, and accreditation standards
- Billing and coding
requirements, cost reporting and reimbursement requirements
- Requirements affecting
patient care, including credentialing, utilization review, peer review,
and medical staff requirements
- Health Insurance Portability
and Accountability Act (HIPAA) laws regarding the privacy and security of
personal health information
- Emergency Medical Treatment
and Active Labor Act (EMTALA)
- Clinical research laws, such
as informed consent, adverse event reporting and Review Board processes
- Electronic health records
and related matters
- Telemedicine
- Bioethical issues
We have
conducted healthcare-related due diligence and hundreds of internal
investigations. Our attorneys have extensive experience in the development,
implementation, and evaluation of compliance programs for various providers,
such as hospitals, home health agencies, and nursing home facilities, including
conducting comprehensive training and preparing and revising policies and
procedures for clients. All-too-frequent headlines announcing recent instances
of healthcare fraud have made corporate responsibility and accountability a
major focus of healthcare entities. Our experience allows us to craft
compliance programs that are designed to effectively meet the requirements set
forth by the federal and state governments.
Operations
In
representing our healthcare clients, we strive to understand the demands of
their business and to make their goals our own. Our multidisciplinary legal
skills allow us to provide clients with guidance involving the range of legal
issues that confront businesses in the healthcare industry. These include many
operational issues such as contract drafting and negotiation, labor and
employment, immigration, tax, the Employee Retirement Income Security Act
(ERISA) and employee benefits, insurance coverage, intellectual property
protection, preparing and negotiating clinical trial agreements, assisting with
the establishment of clinical trial processes and procedures, and other
operational matters.
Our experience also covers emergency
preparedness and response, advising clients on pandemics, mobilization during
natural disasters, and disaster recovery.
