Health Law
The health care industry faces both challenge and new opportunity. Government and industry sponsored reform initiatives, broadening HMO market penetration, and regulatory restrictions on compensation and referral arrangements challenge hospitals and physicians to restructure the ways in which health care services are delivered. At the same time, the changes expected of health care providers and practitioners present new opportunities for survival, growth and prosperity.
Meeting these challenges and realizing these opportunities involves not only comprehensive knowledge and astute application of the law, but also a clear understanding of health care as a business. To this end, Phillips Nizer's Health Law practice group combines years of experience in health and health-related legal matters with hands-on knowledge of health care operations, market trends and economics. We emphasize the development of pragmatic approaches to synergize regulatory compliance with market opportunities.
Representative Matters
The Firm’s Health Law practice includes representation of large academic medical centers, community hospitals, nursing homes and home health agencies.
Some examples of the services provided by the Firm include:
- Understanding the impact of cost constraints on institutional providers. Guiding clients through the complex legal issues involved in work force productivity programs and the "right-sizing" of hospitals. In connection with the “right-sizing” issue, one of our attorneys worked with the New York State Governor’s Healthcare Reform Working Group and assisted in the formulation of key recommendations which have since been adopted by the state;
- Compliance with the Standards for Privacy of Individually identifiable Health Information (HIPAA);
- Developing innovative programs advantageous to specialists as well as hospitals and primary care physicians;
- Counseling practitioners in the formation of specialty and sub-specialty IPAs. By analyzing epidemiological and reimbursement trends, our attorneys have been instrumental in identifying and implementing "niche" market opportunities in areas as diverse as rehabilitative medicine, long-term care, and home health care and pharmacy operations;
- Establishing integrated PHOs to maintain both hospital/medical staff cohesiveness and market share in a managed care environment;
- The establishment and operation of managed care entities such as HMOs, PHOs, PPOs and integrated delivery systems;
- Negotiating outsourcing contracts for health care institutions seeking to reduce staffing expenses;
- Drafting policies to comply with federal and state regulatory policies;
- Defending hospitals and physicians against litigations commenced by former employees, contractors or providers;
- Representation of health care institutions in seeking reimbursement for services provided from third party payors and/or government entities;
- Assisting health care entities in securing state regulatory approval and Certificates of Need for new construction projects;
- Medical staff issues;
- Labor and Employment issues, including defense of benefit claims brought by participants pursuant to ERISA preemption;
- Workforce productivity;
- The establishment and legal issues involved in operating nursing homes and home health care companies;
- Health care mergers and acquisitions;
- Health care venture financing;
- Out-patient and diagnostic imaging facility development;
- Medicare and Medicaid fraud investigations;
- Regulatory compliance; and
- Corporate structuring of health care organizations.
The Health Law practice group also calls upon and works closely with the firm's other practice groups on a wide range of matters affecting health care clients, such as: Insurance, including products liability coverage issues; OSHA compliance; Toxic and hazardous waste management programs and liability exposures; Antitrust issues; and Exempt organization tax issues.
Attorneys with the firm are well-regarded authorities on important healthcare related topics. One of our attorneys has presided for the past four years over a presentation by the directors of the Civil and Criminal Fraud Units in the United States Attorney’s Offices of the Southern and Eastern Districts of New York on current issues in enforcement of federal healthcare laws including the Stark self-referral laws and federal fraud and abuse anti-kickback laws.
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