Healthcare

Successful Counsel for the Modern-Day Healthcare Industry

In 2017, healthcare became the largest source of jobs in the nation. Healthcare 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

September 22, 2021
Attorney News

Jackson Walker Congratulates Its 57 “Texas Super Lawyers” of 2021

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.

Vaccination medical syringe with Jackson Walker logo

September 17, 2021
Insights

CMS to Require Vaccinations for Workers at Medicare and Medicaid-Certified Facilities

By Jed Morrison

The Centers for Medicare & Medicaid Services (CMS) has announced that it will issue emergency regulations expanding its requirement for nursing home staff to be vaccinated to include workers at Medicare and Medicaid-certified hospitals, dialysis facilities, ambulatory surgical settings, and home health agencies, among others.

August 19, 2021
Attorney News

‘The Best Lawyers in America’ Honors 178 Jackson Walker Attorneys in 2022 Edition, Including 8 “Lawyers of the Year” and 31 “Ones to Watch”

The Best Lawyers in America has recognized 178 Jackson Walker attorneys across 6 offices and 67 specialty practice areas in its 2022 edition, including 8 Lawyers of the Year and 31 Ones to Watch. Best Lawyers listings are based on an exhaustive peer review survey of thousands of attorneys who vote on the legal abilities of others in their practice areas.

Laptop and stethoscope for healthcare

August 18, 2021
Podcasts

Navigating Potential COVID Relief and Healthcare Fraud Issues

~10 minutes | With a dense thicket of regulations to comply with, businesses may trigger a governmental investigation if they are not familiar with the complex and changing rules and regulations surrounding COVID relief funds, particularly in the healthcare sector. In this interview about the Department of Justice’s crackdown on fraud, Arthur Gollwitzer discusses how businesses can protect themselves and what to do when approached by the authorities.

Jeff Drummond with Jackson Walker logo

August 13, 2021
Mentions

Still Missing a New Leader, Former OCR Directors, Experts Offer Advice, Task List | Report on Patient Privacy

Issue a final rule revising the privacy regulation and write guidance on the information blocking rule. Formalize the fledgling audit program required by Congress more than 10 years ago. Engage with providers and other HIPAA-regulated entities. And by all means, get cracking.

Healthcare worker stethoscope scrubs with JW logo

August 9, 2021
Mentions

How Texas Is Protecting Healthcare Workers Fighting COVID-19 | D Magazine

With the Pandemic Liability Protection Act in effect, Denise Rose spoke with D Magazine about the protections afforded to physicians and other health care workers treating patients who have tested positive for COVID-19.

Colorado River and downtown Austin

August 3, 2021
Attorney News

‘Austin Monthly’ Lists 20 Jackson Walker Attorneys Among “Austin’s Top Attorneys” of 2021

Jackson Walker congratulates the 20 attorneys recognized among “Austin’s Top Attorneys” for 2021. For recognition in the list, Austin attorneys must be nominated by their peers on the basis that they offer experienced counsel in one of 43 categories.

Healthcare worker stethoscope scrubs with JW logo

June 11, 2021
Insights

OSHA’s Emergency Temporary Standard for Occupational Exposure to COVID-19

By Sara Harris

The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) COVID-19 workplace safety rules have been long in the making. On June 10, 2021, OSHA finally issued those rules in the form of an Emergency Temporary Standard (ETS). Coming as a surprise to many who were expecting broad rules that would apply to all workplaces, the ETS instead covers only workers in the healthcare industry.

Vaccination medical syringe with Jackson Walker logo

June 10, 2021
Mentions

Is It Legal for Businesses to Require Customers to Be Vaccinated? | Daily Caller

On June 20, 2021, Foo Fighters will perform at Madison Square Garden with only vaccinated people allowed to attend the full-capacity concert. In a Daily Caller article discussing the legality of private businesses refusing services to customers based on their vaccination status, Jeff Drummond noted: “HIPAA isn’t an issue. HIPAA only applies to health plans, health care data translation companies (called “health care clearinghouses”), and most (but not all) health care providers. Airlines, restaurants, landlords, and non-health care business owners are not subject to HIPAA.”

May 20, 2021
Spotlight

Chambers and Partners Recognizes Jackson Walker Attorneys and Practices in 2021 USA and Global Guides

Jackson Walker is pleased to announce that Chambers and Partners has selected 41 attorneys and 14 departments for inclusion in the 2021 edition of the Global and USA guides.

More Healthcare 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.