Health Care

Overview

Our attorneys represent a broad spectrum of health care clients (including facilities, practitioners and payors) regarding federal and state legal issues. Our years of experience with the health care industry provide us with an acute understanding of providers, as well as of the related businesses that are part of the health care system. We counsel clients on matters that are unique to the health care industry, as well as the broader corporate, tax, and regulatory matters that all U.S. business entities face today.

Our industry-specific services include:

Fraud and Abuse/Self-Referral Regulation

  • Analyze and structure transactions to comply with state and federal laws
  • Compliance plans and training
  • Structure compliant practitioner practice arrangements

Enforcement Actions

  • Civil and criminal false claim investigations and enforcement actions
  • Qui tam (whistleblower) litigation
  • Representation before the FTC, Department of Justice, federal and state legislatures and agencies
  • Payor audits

Licensure and Certification

  • Secure initial Medicare certification for new providers
  • Departicipation proceedings/draft plans of correction
  • Licensure surveys
  • Coordinate licensure and certification during changes of ownership
  • Practitioner scope of practice issues

Certificate of Need

  • Develop CON strategy and conduct agency negotiations
  • Prepare CON applications
  • Advise regarding payor "evidence of necessity" requirements

Accreditation

  • Counsel regarding accreditation standards
  • Represent clients in connection with denial and termination of accreditation

Third-Party Payment

  • Negotiate managed care and other payment contracts
  • Medicare, Medicaid and payor payment disputes (internal appeals and litigation)
  • Medicare PRRB appeals
  • Analyze reimbursement consequences and related compliance issues
  • Counsel regarding compliance with payor requirements

Managed Care

  • State and federal regulation of managed care organizations, including license and reserve requirements
  • Provider and subscriber contracts
  • Permissible risk and payment arrangements

Medical Staff

  • Medical staff bylaws and rules
  • Policies (e.g. impaired practitioners and codes of conduct)
  • Contested medical staff proceedings
  • National Practitioner Data Bank and state reporting obligations

Financing

  • Income and property tax advice, including tax-exemption issues
  • Tax-exempt and other financing
  • Analysis of private use and change-of-use limitations
  • FHA-Insured financing/ HUD Section 232 loans for long-term care facilities

Patient Care Issues

  • End-of-life care and medical ethics issues
  • Consent policies and forms
  • Specialized treatment issues (e.g. mental health, substance abuse, AIDS)
  • Difficult discharge planning cases

Clinical Research

  • IRB compliance
  • Research contracts
  • FDA audits

Emergency Services

  • EMTALA requirements and enforcement proceedings
  • Medical control authorities

Professional Liability

  • Litigation defense
  • Draft and review policies to reduce liability risk

With regard to general corporate counsel to health care clients, Dykema lawyers assist clients with the following: 

  • Reorganizations, acquisitions, mergers, affiliations and joint ventures 
  • Representation before the FTC, Department of Justice, federal and state legislatures and agencies 
  • Securing and maintaining tax-exempt status 
  • Antitrust counsel on mergers, consolidations, joint ventures and physician contracts 
  • Income and property tax advice 
  • Contracts, including outsourcing contracts and educational affiliations
  • Employment policies and litigation 
  • ERISA and related issues 
  • Federal and state campaign and lobbying statutes 
  • Intellectual property, such as patents, trademarks and service marks 
  • Joint and cooperative ventures with a broad range of entities
  • Employment practices and litigation 
  • Labor issues, including collective bargaining and contract negotiation 
  • Real estate, land use, and construction matters

Speaking Engagements