Hospitals and Health Systems


Driven by a thorough understanding of the complex regulatory environment and operational issues facing today’s acute care facilities, Dykema provides sophisticated counsel to hospitals and health systems on a wide range of issues. Hospitals and health systems need a legal partner they can trust to ensure their operations comply with the ever-changing federal and state laws governing healthcare.

Our team represents hospitals and health systems in the full spectrum of transactional matters, including joint ventures, initial entity formation, mergers and acquisitions, and the conversion of nonprofit to for-profit entities.

Our lawyers understand the special considerations that affect hospital and health system business arrangements and help clients develop innovative strategic alliances, partnering arrangements, and research development collaborations. 

We also help our clients meet their financing needs, whether through conventional means or tax-exempt bond financing.  We represent hospitals in connection with ground lease projects, including medical office buildings, new hospitals, and urgent care projects.

We help clients:

  • Navigate the complex Medicare and Medicaid payment requirements, such as provider-based criteria, anti-markup on diagnostic tests, and “under arrangements” services
  • Structure desired financial relationships with referring physicians to comply with the Stark Laws, fraud and abuse laws, and restrictions imposed by tax-exemption
  • Comply with licensing and Medicare certification requirements, including “changes of ownership” and CMS-855 revalidation
  • Obtain certificates of need (CON) and comply with their requirements
  • Avoid fraud and abuse problems, respond to audit investigations, civil investigative demands, and aid in making self-disclosures
  • Respond to healthcare reform measures
  • Comply with accreditation requirements and defend appeals (Joint Commission, AOA, AAAHC)
  • Deal with the legal issues raised by electronic health records and HIPAA/HITECH

We provide complete employment and employee benefits counsel to our hospital and health system clients, from advising on general applicable employment and labor laws and executive compensation to negotiating and drafting professional services agreements, preparing medical staff bylaws, and developing creative physician hospital affiliation structures that comply with all applicable healthcare laws and regulations.

We also help clients with their credentialing and peer review needs and represent hospitals and medical staffs in contested medical staff hearings and appeals.

Our government policy lawyers and regulatory advisors offer guidance on state and federal legislative matters that impact the healthcare industry, including legislative solutions to client problems. Our work for hospitals includes government contracts, grants and research agreements, export control and technology transfers, and campaign finance compliance.

Dykema’s tax lawyers are well-versed in the complexities of federal, state, and local tax law and provide high level representation on the full range of tax issues to our hospital and health system clients. Where applicable, we help our clients obtain and retain their tax-exempt status, craft strategic solutions that defer or reduce tax liabilities, and represent clients in adversarial tax proceedings, including property tax appeals.

We represent hospitals and health systems in structuring and negotiating transactions involving the acquisition of technology-based products and outsourced services.

Our team provides exceptional leadership and guidance in transactions that include everything from information technology outsourcing and business process outsourcing, to software licensing and development agreements, including cloud computing services agreements.

For outsourcing transactions, we assist with the strategy and preparation, RFP process, vendor evaluation and selection, contract negotiations, and dispute resolution after execution.

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