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Health Care

Spencer Fane’s Health Care team shares the perspective, knowledge, and creativity needed to guide clients through the unchartered waters of health care reform.

At this very moment, the health care industry stands on the cusp of unprecedented change. Issues like access to health care, proposed payment changes in relation to Medicare, the growth of health information technology, along with the government’s more aggressive fraud-fighting strategies, are forcing providers to re-envision how they operate. Hospitals and physicians are desperate for insight on how these changes will impact them and direction on how to proceed. Spencer Fane combines our specialized experience with a proactive approach and a commitment to our clients' success, making us the most effective choice for health care legal matters.

Our health care practice group spans a broad spectrum of heath care providers including hospitals, hospital medical staffs, surgery centers, clinical laboratories, managed care entities, multi-specialty provider groups, single specialty provider groups, solo practice physicians, and other licensed providers. Led by our core group of health care attorneys, our team includes attorneys from other legal disciplines who have significant experience working with health care providers. Our attorneys specializing in corporate, financial services, real estate, environmental, labor and employment, insurance, and employee benefits law work together to provide comprehensive solutions to complex problems helping our health care clients succeed in today’s challenging environment.

Our health care team is experienced in the following areas:

Contracts - preparation, negotiation, and analysis of agreements while ensuring compliance with applicable laws, including Anti-kickback, Stark, and Civil Monetary Penalty laws.

  • Hospital/physician contracts 
    • Physician and other health care provider employment contracts and independent contractor arrangements 
    • Physician recruitment contracts
  • Vendor agreements
    • Electronic health record and information systems
    • Supply chain
    • Services
  • Practice acquisition contracts
  • Managed care and third-party payor contracts
  • Employment agreements for executives and staff
  • Real estate purchase contracts (including financing) and space leases
  • Equipment purchase contracts and leases


Corporate Governance, Transactions, and Compliance

  • Counseling and advisement of governance boards
  • Compliance
    • Corporate compliance plans
    • Statutory and regulatory compliance policies and audits
    • HIPAA (Health Insurance Portability and Accountability Act) compliance policies, training, and breach management
    • Stark
    • Anti-kickback
    • EMTALA (Emergency Medical Treatment and Active Labor Act)
  • Mergers, acquisitions, and joint ventures involving physicians, hospitals, and other entities in the health care industry, and compliance with relevant laws, e.g., Stark (physician self-referral), Anti-kickback and antitrust
  • Physician integration models
  • Corporate/governance bylaws
  • Entity selection and restructuring
  • Finance 
  • Internal investigations


Licensure and Accreditation

  • Facility licensure 
  • Professional licensure 
  • State, Joint Commission on Accreditation of Healthcare Organizations, and Healthcare Facilities Accreditation Program accreditation issues.


Medical Staff

  • Bylaws and regulations 
  • Credentialing policies and procedures 
  • Peer review including fair hearing plans, investigations, and hearings
  • Restructuring of Medical Staff to address increased emphasis on quality and utilization


Reimbursement

  • Medicare and Medicaid denials and appeals
    • Recovery Audit Contractor (RAC)
    • Medicare Administrative Contractor (MAC)
    • Medicaid Integrity Contractor (MIC)
    • Quality Improvement Organization (QIO)
  • Third-party payor and managed care denials and appeals