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Health Care

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

Contracts

  • 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

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 & 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