Barron P. Bogatto is a partner in the Health Care and Corporate & Securities Sections of Jackson Walker. Mr. Bogatto's corporate and regulatory practice centers almost exclusively in the provision of comprehensive legal services to the health care industry. Since beginning practice in 1986, he has advised health care providers of all types in matters relating to Medicare, Medicaid, and other governmental program laws and regulations; reimbursement controversies; administrative appeals; corporate, real estate, finance, joint ventures, and other business transactions; corporate and regulatory compliance matters; operational and employment matters; and the formation and operation of provider networks. Mr. Bogatto has substantial experience regarding health care regulatory issues and restrictions involving health care fraud and abuse, false claims, and physician anti-referral matters affecting health care joint ventures and integrated delivery systems; hospital/physician relationships; and hospitals, clinics, and other providers.
In his practice, Mr. Bogatto handles health care joint ventures; mergers and acquisitions; tax-exempt financings; entity formation and private placement securities offerings; creating and restructuring business organizations and provider networks; health facility licensure, accreditation, and changes in ownership; reimbursement disputes with Medicare and Medicaid agencies and appeals before the Provider Reimbursement Review Board; representing providers in matters involving CMS and the OIG, including self disclosures under the OIG's self disclosure protocols; creating and implementing compliance plans and conducting internal audits and investigations; negotiating and drafting various health care contracts (e.g., asset and stock purchase agreements, merger agreements, loan agreements, medical office leases, master leases, subleases, construction and health facility development contracts, employment and non-competition agreements, physician practice acquisition documents, physician recruitment and income guarantee agreements, health facility sale and lease documents, full service management agreements, managed care and capitation contracts, etc.); and issuance of relevant legal opinions relating to such matters.
Over the course of his career, Mr. Bogatto has actively represented:
- national for-profit health care systems
- a non-profit hospital system with facilities in several states
- individual for-profit and non-profit acute care hospitals (both urban and rural)
- Texas hospital authorities and hospital districts
- one of the largest children's specialty hospitals in the nation
- state sponsored medical schools, academic medical centers, and teaching hospitals
- numerous certified non-profit healthcare organizations (a/k/a 5.01a corporations)
- home health care agencies
- rural health clinics
- imaging centers
- ambulatory surgery centers
- cancer treatment facilities, a proton therapy and IMRT radiation therapy facilities
- clinics and large physician single and multi-specialty groups, including internists, family practitioners, pediatricians, orthopedists, OB/Gyns, anesthesiologists, ER physicians, radiologists, pathologists, rheumatologists, oral surgeons, ophthalmologists, and other sub-specialists
- physician practice management companies
- individual physicians and dentists
- biotechnology companies
- telemedicine providers
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- Mergers and Acquisitions
- Represented a Texas Hospital District in the sale of its acute care hospital and related facilities to a national for-profit hospital company with requirements for the company to build the community a new state-of-the-art hospital facility and provide on-going indigent care at specified levels.
- Represented a non-profit hospital system in the acquisition of an acute care hospital from a national for-profit hospital company and later merged the acquired hospital into the non-profit hospital company's original hospital subsidiary.
- Represented a children's specialty hospital in the creation and structuring of its 5.01a Texas Certified Nonprofit Healthcare Organization and the purchase of over 30 multi-physician group practices valued over millions of dollars in the aggregate and the employment of over 120 pediatricians.
- Represented a Texas non-profit health care system in the creation and structuring of its 5.01a Texas Certified Nonprofit Healthcare Organization for primary care and the purchase of at least eight physician practices and the employment of over 30 physicians.
- Represented a national for-profit hospital company in its acquisition of two west Texas physical therapy practices.
- Represented a national for-profit home health company in selling two of its Texas home health agencies.
- Represented a children's specialty hospital in the acquisition of a home health company's assets and operations.
- Represented a large physician owned medical group in the $21,000,000 sale of its for-profit management company to a national for-profit physician management company, involving stock transfers, stock options, convertible debt, securitization of debt, the employment of key executives, and administrative services agreements between the management company and the physician clinics.
- Represented a Dallas ophthalmologist in the sale of his ambulatory surgery center.
- Represented a Texas health maintenance organization in the sale of its assets and assignment of its provider, beneficiary, and Medicare/Medicaid contracts to a national insurance company.
- Represented a Texas dentist in the purchase of a dental practice from a retiring dentist.
- 5.01a Texas Certified Non-Profit Healthcare Organizations
- Represented a consortium of several Texas non-profit hospitals and certified non-profit health care organizations in making comments to the Texas State Board of Medical Examiners (now the Texas Medical Board) as the Board promulgated its most recent rules regarding the initial and ongoing certification of non-profit healthcare organizations under the Texas Medical Act.
- Represented at least eight different 5.01a Texas Certified Non-Profit Healthcare Organizations in their structuring, obtaining 5.01a certification from the Texas State Board of Medical Examiners (now the Texas Medical Board), obtaining tax-exempt status, transferring funds to and from their non-profit corporate member, purchasing physician practices valued in the millions of dollars, and employing hundreds of physicians.
- Health Care Real Estate
- Represented a Texas hospital authority in a medical office building monetization project soliciting public bids for the long-term lease and management of its current medical office buildings and the construction of a new medical office tower on the campus.
- Represented a national for-profit hospital company in its medical office building development agreements, master leases, and physician leases and sub-leases for three of its Houston hospitals.
- Represented a national for-profit hospital company in its development and construction agreements with a real estate development company for the construction of a two-story medical office facility and its subsequent lease to a large physician clinic.
- Represented a Texas non-profit specialty hospital in the acquisition of over 40 acres via purchase and gift for the development of the hospital's new west Houston hospital campus.
- Represented a for-profit hospital company in the long term master lease of its entire hospital facility to a non-profit hospital system for operation of the hospital.
- Represented a non-profit specialty hospital in its development and build-to-suit construction agreements with for-profit developers and contractors for the development of several of its satellite health centers for sub-specialty medical services.
- Represented a large multi-specialty physician clinic in negotiating an early termination of its lease of its significant medical office space with a non-profit hospital's affiliate and negotiation of a new medical office building lease with a for-profit hospital's medical office building affiliate.
- Tax-Exempt Bond Financings
- Represented various hospital districts, hospital authorities, non-profit hospital systems, and non-profit hospitals across the country as bond counsel, underwriter's counsel, and borrower's counsel in the issuance of over $750,000,000 aggregate in tax-exempt bonds.
- Public Law Matters
- Represented Texas hospital districts and hospital authorities in various public law issues involving Texas open meetings laws, Texas open records laws, seeking Texas Attorney General Opinions, Federal Freedom of Information Act (FOIA) requests, competitive bid projects, etc.
- Joint Ventures
- Represented a national for-profit hospital company in its initial limited partnership offering for one of its medical centers and a subsequent follow-up offering.
- Represented a group of five orthopedic surgeons in their investment in an orthopedic ambulatory surgery center.
- Represented a group of over ten pediatric orthopedic surgeons in their investment in an ambulatory surgery center for orthopedic matters.
- Represented a for-profit company in structuring its joint ventures for three radiation therapy centers in Houston, Austin, and Louisiana providing IMRT services for urology group practices, development of the purchased services and management services agreements, and drafting of the appropriate private placement memorandums and other offering documents.
- Represented a public hospital company in unwinding several physician joint ventures that owned and operated major medical equipment.
- Represented a for-profit company in negotiating a joint development agreement with a specialty cancer hospital for the production of radioisotopes and research regarding same.
- Represented a national for-profit hospital company in its initial limited partnership offering for development of a birth center at its Houston women's hospital.
- Represented an oncologist in purchasing a limited liability company interest in an Arlington cancer center venture.
- Represented an affiliate of a Houston specialty cancer center that provides cancer center management and therapeutic services in a joint venture with another Ft. Worth cancer center.
- Provider Reimbursement Review Board (PRRB) Medicare Appeals
- Represented a national for-profit hospital company specializing in rural providers in settling a group appeal for six of its hospitals for acquisition interest expense before the PRRB for over $10,000,000 aggregate Medicare reimbursement.
- Represented a national for-profit hospital company specializing in rural providers in a successful appeal for one of its hospitals before the PRRB and CMS Administrator of several Medicare reimbursement issues recovering over $2,000,000 Medicare reimbursement.
- Represented a California hospital system in a successful PRRB appeal and CMS Administrator Decision for reimbursement under an improperly denied SNF exemption with a reimbursement effect of several hundred thousand dollars for each of several cost reporting periods.
- Represented a Michigan hospital system in the favorable settlement of numerous PRRB appeal reimbursement issues with a cumulative favorable reimbursement effect of several million dollars.
- Represented a national for-profit hospital company specializing in rural providers in the favorable settlement of numerous PRRB appeal reimbursement issues with a cumulative favorable reimbursement effect of several million dollars.
- Represented a Texas hospital district in its Medicare appeals before the PRRB and Federal District Court regarding changing the useful lives of two of its hospital facilities.
- Organization and Reorganization of Physician Practices
- Represented a large anesthesiology group in restructuring its professional limited liability company and buy-sell agreements, adding new members, and satisfactorily resolving issues with a departing member.
- Represented a large radiology group practice in restructuring its limited liability partnership and buy-sell agreements, adding new partners, and developing its new independent contractor agreements.
- Represented numerous physicians and oral surgeons in joining and buying into various medical practices.
- Hospital Contracts
- Represented a non-profit hospital in the development of its entire integrated delivery system.
- Represented various non-profit and for-profit hospitals, as well as physician groups, in contracts involving provider-based physicians (e.g., radiologists, pathologists, ER physicians), medical directors, physician recruitment, teaching physician duties, etc.
- Represented a children's hospital in development its coverage agreements with a medical school for specialist and sub-specialist services at its provider based suburban health centers.
- Represented various non-profit, for-profit, and public hospitals and other health care providers in sale, lease, financing, and maintenance transactions involving complex medical equipment.
- Represented a public hospital in its contract for development and operation of a wound care center.
- Represented a for-profit company operating a proton therapy center in its coverage and transfer agreements with a specialty cancer hospital.
- Physician Employment and Recruitment
- Represented innumerable health care providers as well as individual physicians, dentists, oral surgeons on both the employer's and employee's side in employment, retention, coverage, and independent contractor agreements.
- Represented various hospitals, medical groups, and physicians from each perspective in numerous physician relocation and recruitment arrangements.
- Compliance and Self-Reporting
- Represented a non-profit hospital in settling an appeal involving a HCFA TIPPS review with HCFA (now CMS) and the Medicare fiscal intermediary that saved the Hospital over $1,000,000.
- Represented a teaching hospital in making a self disclosure to the OIG regarding certain issues involving its teaching physicians and their supervision of residents as well as negotiated a settlement of same without fines or the need for a corporate integrity agreement.
- Represented a non-profit hospital system in making a self disclosure to the OIG regarding certain arrangements with a medical group that employed a physician who was an excluded provider, and negotiated a settlement of same without fines or the need for a corporate integrity agreement.
- Represented a medical school in self reporting certain issues involving grants and resolving same with the OIG and National Institute of Health.
- Represented various hospitals and physician groups in internal audits and investigations to identify and resolve billing errors and other compliance issues, and self-reporting such errors to the appropriate Medicare fiscal intermediary and Medicaid carrier, and repayment of amounts in error without penalties.
- Represented hospitals in drafting their corporate compliance plans.
- Performed internal investigations and legal audits for various healthcare providers.
- Academic Medical Centers and Teaching Hospitals
- Represented medical schools in Texas and Michigan regarding various issues involving direct graduate medical educations (GME) reimbursement and indirect graduate medical educations (IME) reimbursement.
- Represented various medical schools in issues involving teaching physicians, supervision, and moonlighting residents.
- Represented a north Texas teaching hospital in negotiating its affiliation agreement with the medical school supplying teaching physicians and interns, residents, and fellows.
- Represented a medical school in developing a services agreement to provide telemedicine services to a maritime company's ships overseas.
- Represented a physician organization, whose physicians provide medical services around the globe, particularly in remote locations, utilizing telemedicine technologies.
More about Barron P. Bogatto: Biography | Involvement | Recognition | Speeches / Publications | News
Mr. Bogatto is a member of the College of the State Bar of Texas, an honorary society chartered by the Supreme Court of Texas to recognize and represent lawyers who make an extraordinary commitment to professional education. He is also a member of the State Bar of Texas' Health Law and Real Estate Sections, the American Bar Association's Health and Business Law Sections, the American Health Lawyers Association, the Health Care Financial Management Association, the Health Care Compliance Association, and the Houston Bar Association. Mr. Bogatto is listed in the "Red Book" as a bond counsel. He is a past President and former council member of the Houston Bar Association's Health Law Section and he is a current member of the Outreach Committee of the State Bar of Texas Health Law Section.
Mr. Bogatto is on the board of directors for two Houston health care non-profit organizations: The Houston Area Immunization Partnership and The San José Clinic, one of the oldest charity clinics in the United States, providing health care to the uninsured since 1922.
More about Barron P. Bogatto: Biography | Experience | Recognition | Speeches / Publications | News
Mr. Bogatto is listed in the 2006-2013 editions of The Best Lawyers in America under Health Care Law. He is AV Preeminent rated in health care law by Martindale-Hubbell and was recognized in the February 2012 edition of Corporate Counsel for this honor.
More about Barron P. Bogatto: Biography | Experience | Involvement | Speeches / Publications | News
Speeches / Publications
Mr. Bogatto has authored articles and e-Alerts on various health law topics and is a frequent lecturer including presentations for the Texas Association for Healthcare Financial Administration, the Texas Hospital Association, the State Bar of Texas Health Law Section, Baylor College of Medicine/Rice University Executive Education Program, Texas Society of CPAs, and the University of Houston Law Center's Health Law Institute.
Links to Publications
More about Barron P. Bogatto: Biography | Experience | Involvement | Recognition | News
B.A., The University of Texas at Austin
J.D., University of Houston Law Center