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