Healthcare & Life Sciences

Successful Counsel for the Modern-Day Healthcare Industry

The healthcare sector is one of the largest sources of jobs in the nation and is also one of the country’s most highly regulated industries. Shifting consumer demands, increased regulations, and reduced government funding have put healthcare providers under pressure to improve quality of care while simultaneously decreasing costs. The challenge of doing more with less is magnified further by the complex interaction of legal issues from a wide range of practice areas that healthcare entities face every day.

Stellar legal counsel in the highly-regulated, modern-day healthcare environment requires a combination of industry-specific technical and tactical knowledge, business acumen, a broad base of relevant legal experience, and the ability to craft creative, practical, and effective strategies and solutions to the issues and pressures facing the healthcare entities of today. Jackson Walker offers just that.

Legal Prowess and Client Service – The Perfect Combination

By combining our knowledge of the ever-changing legal landscape with our commitment to understand the mission and objectives of our clients, we are able to tailor our advice and counsel to support the achievement of each client’s particular objectives, offering providers and other healthcare entities the insight, information, legal advice, and guidance they need to navigate these issues and challenges.

We see our clients as individuals and entities dedicated to the health of our country, and we consider it a privilege to help them achieve their business goals. We pride ourselves on our responsiveness and reliability and, we hope, our ability to be the kind of lawyers that clients enjoy working with.

Multi-Disciplinary Approach

Jackson Walker is a full-service law firm. In addition to our outstanding Healthcare attorneys, we have sophisticated teams of lawyers skilled in the many areas of law that regularly impact healthcare entities. Our Healthcare team works hand-in-hand with experienced attorneys in our Real Estate, Finance, Tax, Corporate & Securities, Bankruptcy, Labor & Employment, and Governmental Affairs practice groups to seamlessly provide the advice and guidance that will help our healthcare clients successfully navigate this challenging business and regulatory environment.

Healthcare Advice Every Step of the Way

Jackson Walker has the experience and resources to help our healthcare clients with all their legal needs. We help physicians, hospitals, healthcare systems, and other medical providers create, change, or grow their practice through formation, acquisitions, mergers, affiliate agreements, and alliances. We also help with the creation of new relationships with relevant providers, developing financing strategies best suited to their current needs and future growth. We partner with a diverse healthcare clientele, counseling them on a full range of operational matters, including contract negotiations, labor and employment issues, managed care contracting strategies, and measures to increase efficiency and reduce costs. Our attorneys work with our clients to apply for, secure, and comply with licensure, certification, and accreditation requirements and counsel them on the protocols and processes needed to comply with privacy and confidentiality rules. Our Healthcare team is particularly skilled at helping healthcare providers navigate the payor and reimbursement landscape, creating and implementing plans that maximize the likelihood of securing prompt and timely payment and reimbursements.

We routinely assist clients with developing practical, innovative, and effective solutions to the complex issues that arise from the tangled web of rules, public policy, and ever-changing local, state, and federal laws and regulations imposed on healthcare entities by the government and private insurers. When compliance issues occur, we advocate for our clients through  the audit, appeal, investigation, or litigation process.

We guide our clients through every twist and turn of their business journey, doing whatever we can to lessen the business, operational, and regulatory challenges along the way so they can focus on what matters–providing quality, cost-effective care for their patients.

Transactional & Business

  • Represented a children’s specialty hospital in the creation of its 5.01a Texas Certified Nonprofit Healthcare Organization and acquire over 30 multi-physician group practices valued over millions of dollars in the aggregate and the employment of over 120 pediatricians for operation of an integrated healthcare delivery system
  • Represented a very large multi-specialty physician clinic with numerous locations in the private placement offering of new ownership interests, setting up its governance structure, and creation of its Accountable Care Organization (ACO)
  • Represented a radiology practice in the amendment of its partnership agreement to implement new provisions for governance, buyouts, restrictive covenants, senior physician status, and different classes of equity and voting partners
  • Represented senior physician shareholders in the buy-out of their interest in a medical practice and its subsidiary management company prior to the sale of the practice and management company
  • Represented a nonprofit hospital in a joint venture with for-profit company to operate urgent care centers
  • Represented a large physician single specialty 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 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 children’s specialty hospital in the acquisition of a home health company’s assets and operations
  • Represented single specialty physician groups in rollup transactions involving the sale of medical assets to another physician practice group and investment in a related management services organization

Operational & Regulatory

  • Representing hospital clients in matters involving the Centers for Medicare and Medicaid Services and the Provider Reimbursement Review Board (PRRB)
  • Representing healthcare professionals in connection with investigations by their licensure boards and appeals of adverse licensure actions
  • Representing healthcare professionals in passage of legislation affecting regulation of and participation in managed care organizations
  • Advocating and securing increases in Medicaid funding for ICF-IID, Class, HCS and foster care programs, children’s hospitals and rural hospitals, the nursing home and home healthcare industries, vendor drug program, and other healthcare providers
  • Representing hospital clients in legislation to expand the use of telemedicine and telehealth
  • Representing healthcare professionals in the Sunset Commission’s review of their professional licensing board
  • Represented numerous individual physicians defending investigations before Texas Medical Board, with almost completely successful outcomes
  • Successfully reinstate large specialty medical group disenrolled from Medicare program, with full retroactive reinstatement
  • Represented physician establishing concierge medical practice and disenrolling from Medicare participation
  • Represented nursing homes and home health agencies in appeals of Texas license revocation actions
  • Medicare Revocation: Assisted large specialty medical group restore its revoked Medicare certification within one (1) week, with no loss of revenue
  • Stark Repayments: Assisted public hospital with potential Stark overpayment claims. By applying alternative analysis using newly adopted regulations, isolated and mitigated improper referral repayments to $$ thousands rather than original $$ hundreds of thousands
  • Reimbursement Appeals: Represent several hundred Medicare hospitals in federal court group appeal of understated PPS reimbursement
  • OIG Audits: Represent non-profit children’s hospital responding to state OIG Medicaid audits
  • HIPAA Breach: Represented a Medical School in responding to HIPAA breach involving a stolen notebook containing medical information
  • Cyber Attack: Represented a hospital in responding to a cyber attack involving deployment of ransomware

Bankruptcy

  • Represented El Paso Children’s Hospital in its Chapter 11 reorganization, with over $100 million in controversy
  • Represented regional bank secured creditor in the Chapter 11 cases of Victory Medical Center hospitals. Assisted client in structuring a resolution with the Debtors, the Official Committee of Unsecured Creditors and the equity holders of the Debtors to obtain a multi-million dollar recovery on account of the client’s claims
  • Represented regional bank secured creditor in the Receivership and Chapter 11 cases of Cleveland Imaging & Surgical Hospital. Assisted client with DIP loan and note sale resulting in a multi-million dollar recovery on account of the bank’s claims
  • Represented potential purchaser hospital holding company in Chapter 11 case of Westbury Community Hospital, LLC as stalking horse bidder. Assisted client in negotiation and due diligence and ultimately determined that the contemplated purchase was not well-advised

Litigation

  • Representing over 250 hospitals in four hospital systems in federal District Court in case involving potential underpayments for the periods covered by various federal fiscal years because the Secretary of Health and Human Services failed to properly distinguish between patient transfers and discharges
  • Representing a county hospital district in litigation against a terminated emergency department provider group
  • Representing a national telemedicine company in litigation against a state medical board regarding the scope of permitted telemedicine services
  • Represented several radiology practice in litigation against former partners to enforce covenants not to compete
  • Represented a small primary care practice in litigation with an insurance company regarding the practice’s business interruption insurance claims due to hurricane damage
  • Successful arbitration for non-profit hospital in dispute against a managed care company for amounts underpaid for emergency services

Real Estate

  • 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 Texas Hospital Authority to monetize some of its real property by public bid to ground lease it medical office buildings and have the operator agree to update current facilities and develop new additional medical office building and parking garage
  • Represented a national hospital system in the development of a new medical office building for one of its urban campuses
  • Represented a non-profit hospital system in the acquisition of an acute care hospital from a national for-profit hospital company
  • Represented a religious healthcare system in the development of its healthcare campuses across Texas in leasing entire hospital facilities, multiple ground leases to developers for its medical office buildings, and acquisition of land parcels for development of new healthcare campuses and the client’s corporate headquarters

Jeff Frost

March 6, 2024
Speaking Engagements

Jeffrey Frost to Present at TSMSS Annual Educational Conference and Exhibition

Jackson Walker partner Jeffrey H. Frost will deliver two presentations, titled “5 Steps to Take to Reduce Physician Disputes” and “How to Avoid Being the Subject Matter of a Podcast or TV Series” at the 47th Annual Educational Conference and Exhibition hosted by the Texas Society for Medical Services Specialists (TSMSS).

January 17, 2024
Mentions

How to Educate the Board on Quality and Safety as QAPI Expects I Healthcare Risk Management

In this article published by Healthcare Risk Management, Jeffrey H. Frost shared insights on the importance of hospital administrators educating the board of directors on quality and safety issues and what board members should understand about the QAPI program.

Jeff Frost

January 11, 2024
Speaking Engagements

Jeffrey Frost to Present at Texas Hospital Association Annual Conference

Jackson Walker partner Jeffrey H. Frost is scheduled to present at the 2024 Texas Hospital Association (THA) Annual Conference on February 15-16 at the Hyatt Regency Dallas.

Jeff Frost

December 14, 2023
Speaking Engagements

Jeffrey Frost Presents “Medical Staff Counsel Unplugged”

On December 13, 2023, Jackson Walker partner Jeffrey H. Frost led a webinar for the Texas Society for Medical Service Specialists (TSMSS), where he shared insights from his 15 years of experience as in-house counsel overseeing a medical staff program for a health system comprising 25 hospitals, medical staffs, 5,000 aligned physicians, and numerous surgery centers.

2024 Best Law Firms announcement

November 2, 2023
Spotlight

Jackson Walker Earns 25 National and 134 Metro Rankings in 2024 Edition of “Best Law Firms”

Jackson Walker proudly announces the firm’s inclusion in the 2024 edition of Best Law Firms® by Best Lawyers. This year, Jackson Walker observed notable improvements in the national rankings, including the rise of Appellate Practice to Tier 1, Banking and Finance Law and Litigation – Labor and Employment to Tier 2, and the addition of Energy Law and Environmental Law in Tier 3.

October 17, 2023
Insights

Texas Attorney General Opinion Finds That Governor’s Emergency Executive Orders Have “The Force and Effect of Law,” Including Criminal Penalties

On September 10, 2021, Williamson County Attorney Dee Hobbs requested an “expedited” ruling from Texas Attorney General Ken Paxton in response to his question of whether executive orders issued by Abbott in response to the COVID-19 pandemic should be “criminally enforceable,” including against public servants who violate the orders. Just over two years later – on September 14, 2023 – he received this reply.

By Kate Goodrich

October 4, 2023
Speaking Engagements

Jamila Brinson and Nick Diamond to Speak at the 36th Annual Texas Health Law Conference

Jackson Walker partners Jamila M. Brinson and Nicholas “Nick” Diamond are scheduled to present during the 36th annual Texas Health Law Conference (THLC), presented by the Health Law Section of the State Bar of Texas at the AT&T Hotel and Conference Center in Austin, Texas, on October 9-10, 2023.

Flags flying at the Texas Capitol

September 19, 2023
Attorney News

Jackson Walker Congratulates Its “Texas Super Lawyers” of 2023

Each year, less than 5% of attorneys in Texas are named to the list. Selection is based off of peer nominations that are then reviewed by a research team. Each nominee is evaluated on his or her professional accomplishments, peer recognition, and community involvement.

September 11, 2023
Insights

September Signals Start of College Football Season and Texas Medical Debt Billing Reforms Under S.B. 490

By Jeffrey H. Frost

As of September, any individual or facility licensed or certified to provide healthcare services in Texas must provide an itemized bill of charges for healthcare services or related supplies provided to a patient prior to requesting payment for such services or related supplies from the patient.

USA flags

August 17, 2023
Attorney News

‘The Best Lawyers in America’ Honors 287 Jackson Walker Attorneys in 2024 Edition, Including 12 “Lawyers of the Year” and 80 “Ones to Watch”

The Best Lawyers in America has recognized 287 Jackson Walker attorneys across 5 offices and 82 specialty practice areas in its 2024 edition, including 12 Lawyers of the Year and 80 Ones to Watch. In this year’s guide, Jackson Walker saw the largest number of attorneys in the areas of Commercial Litigation (66 attorneys) and Real Estate Law (60 attorneys) and the addition of 35 attorneys as Best Lawyers.

More Healthcare & Life Sciences News

  • Corporate Transactions and Entity Formation: Our nationally-ranked Corporate & Securities practice group works with our Healthcare team to advise our diverse healthcare clients in entity formation, sales and dispositions, joint ventures, change of ownership proceedings, development of management services, support and strategic relationships, and other corporate transactions. Our attorneys partner with our clients to develop and implement creative strategies that maximize value, minimize risk, and position our clients for success in their future endeavor, whether they are a buyer, seller, lender, or startup.
  • Mergers and Acquisitions: We regularly represent buyers and sellers in structuring and closing M&A transactions in the highly-regulated and continuously evolving healthcare environment. Our Healthcare team and M&A attorneys work closely together to account for regulatory effects in all phases of merger, acquisition, divestiture, and other change of control transactions. We also identify and resolve critical M&A issues such as valuation and financing expectations and structures, deal structure, pre-merger notification requirements, government approvals, and third-party consent requirements.
  • Alliances: We assist clients in creating, joining, or growing Independent Practice Associations, Physician-Hospital Organizations, and other joint ventures, and in advising these alliances on meeting qualifications as Accountable Care Organizations for purposes of reimbursement. Our attorneys have considerable experience structuring joint ventures, alliances, and relationships between and among physicians, physician groups, hospitals, healthcare systems, and special healthcare service providers.
  • Healthcare Real Estate Assets: With one of the state’s premier Healthcare practice groups and one of the largest Real Estate practice groups in Texas, we are uniquely situated when it comes to providing superb legal counsel and advice on healthcare real estate transactions. Our attorneys are at the forefront of crafting innovative and cost-effective solutions for clients involved in healthcare real estate, whether for a single dentist’s office or a multibillion-dollar hospital campus. Our Healthcare attorneys work with seasoned professionals in our Real Estate, Corporate & Securities, and Tax groups ensuring clients successfully navigate the unique regulatory constraints, business considerations, and tax implications involved in healthcare real estate transactions.
  • Bankruptcy: Our Healthcare team works with our Bankruptcy group to advise our clients regarding distressed health care facilities that may require bankruptcy, reorganization, workouts, loan restructuring, or other creative solutions. Our decades of experience in workouts and restructurings gives us the tools to successfully navigate sophisticated and complex matters for our clients.
  • Finance: Our Healthcare team works closely with the Finance practice group to deftly manage for-profit healthcare equity and debt financing, including private placements and public offerings. We also have considerable experience in healthcare tax-exempt bond financing and refinancing transactions. We offer a broad range of resources and experience to help for-profit and nonprofit clients alike raise capital in a manner most favorable to their business objectives.
  • Tax: Our highly respected Tax team offers comprehensive federal, state, and local tax compliance and tax planning advice to our healthcare clients. We help secure and maintain tax-exempt and nonprofit status, guiding clients in the reporting of unrelated business income, and advising them regarding the tax implications of mergers, acquisitions, and joint ventures. Our attorneys also counsel clients on property tax exemptions and provide representation before the Internal Revenue Service. With experience in federal, state, and local tax matters affecting healthcare, including tax-exempt organizations, tax compliance, tax controversy, and tax litigation cases, our Tax attorneys are available to ensure tax considerations are taken into account whenever appropriate.
  • Governance:  With a keen understanding of both healthcare law and the trends and forces that drive the healthcare market, our seasoned Healthcare attorneys are able to give providers and other healthcare entities quality legal and business advice in all matters related to governance and day-to-day operations. From developing proper procedures and protocols, to negotiating and drafting the numerous contracts required for the business of healthcare, to staff issues, to the rampant rules and regulations that must be complied with, Jackson Walker is there to guide healthcare clients on the path to success.
  • Healthcare Providers: Our multi-disciplinary approach gives us the advantage of being able to counsel healthcare providers on all their legal needs. Whether forming an entity or an alliance, dealing with employees or government agencies, securing contractual interests, reimbursements, or payments, or obtaining licenses or maintaining certifications, we are able to offer insightful, reliable, and effective advice to healthcare providers and implement the appropriate practices so they can get back to what matters most—taking care of their patients.
  • Labor & Employment: Our Healthcare attorneys work closely with our Labor & Employment attorneys to address all of our healthcare industry clients’ employment needs. We draft medical bylaws, personnel policies, and employee manuals, and assist in the formulation of fair hearing procedures. We also counsel clients regarding all federal, state, and local laws applicable to employers and represent clients in contract negotiations, investigations, and hearings. Our benefits and compensation attorneys also work closely with the Healthcare team and our healthcare clients on the development and implementation of all types of traditional benefit plans, including qualified and non-qualified retirement programs and consumer-driven healthcare programs.
  • Licensure, Certification, & Accreditation: We successfully represent healthcare providers, including individual practitioners and facilities, in all aspects of licensure, certification, and accreditation, including state licensure, CLIA certification, Medicare/Medicaid enrollment and participation, Joint Commission, and NCQA accreditation matters.
  • Managed Care: Our Healthcare attorneys draft, review and negotiate managed care agreements for all types of provider entities as well as for managed care organizations. We represent physicians and professional organizations in managed care negotiations, contracting, and payment disputes and advise on managed care strategies with networks and payors. With experience representing managed care organizations, providers, plans, and a plethora of healthcare entities, our attorneys see the managed care experience from all sides, and they are particularly adept at creating plans that work and finding solutions when issues arise.
  • Reimbursements: Consistent payment of reimbursement claims is of vital importance to any healthcare provider. Our Healthcare attorneys have a stellar track record when it comes to ensuring that a provider’s claims are paid. Whether documents need to be reformed, a process needs to be redesigned, or the plan contract needs to be renegotiated, we have the experience, know-how, and relationships with Payors and Plans to see that the proper systems are in place for claims to be paid promptly and in full. We are also particularly successful at facilitating reinstatement for terminated providers.
  • Legislative & Governmental: Our Healthcare attorneys work closely with our renowned Legislative team to represent the interests of healthcare clients on matters pending before the Texas Legislature and various state and federal regulatory agencies. We assist clients with regulatory and legislative analysis, strategic planning, legislature and agency advocacy, and defining healthcare public policy goals.
  • Regulatory Compliance: Regulatory requirements govern every aspect of the way business is conducted and services are delivered in the healthcare industry. We provide comprehensive, insightful advice and assistance in structuring cost-effective corporate compliance and ethics programs, as well as ongoing monitoring and oversight to proactively assist health care clients in the prevention and detection of improper conduct.
  • Fraud and Abuse: We counsel clients on avoiding violations of the Anti-Kickback and Stark laws, the False Claims Act, Civil Monetary Penalties Law, and other federal and state fraud and abuse laws through competent compliance plans, proper procedures, and training to identify risks.
  • Regulatory Defense: When mistakes happen, we assist clients in responding to regulatory investigations and audits at all stages of the process. From meeting with government officials early in an investigation, to conducting full-scale compliance audits and reviews, to actively litigating complex cases, we are there every step of the way advocating for our clients.