National Healthcare Law

Hospitals and Health Systems

• General/Community Hospitals
• Healthcare Systems
• Specialty Hospitals
• Teaching Hospitals/Academic Medical Centers
• Hospital Networks
• Acute Care Hospitals
• LTACHs
• Rehab Hospitals

As the institutions at the center of medical care, hospitals and health systems must manage complex relationships with patients, providers, and payors. Each of these relationships brings unique legal responsibilities and financial challenges. To operate effectively in an era of ever-changing regulation and ever-rising costs, hospitals need advisors who are experienced in diverse areas and can see the big picture. Nelson Mullins' healthcare team provides in-depth knowledge in the full range of legal and operational matters affecting hospital practice which experience includes real world experience as hospital administrators and service as general and/or compliance counsel for a Hospital/Healthcare System. For years our healthcare attorneys have represented and advised all varieties of hospitals and health systems on critical issues such as:

• Financing construction, equipment acquisition and other projects though capital financing, including mortgage-based and cash flow-based financing, and counseling to ensure compliance with state regulations such as certificate of need programs;
• Mergers and acquisitions and other business transactions, from negotiation of terms to financing and tax planning strategies;
• Long- and short-term strategic planning consistent with business goals, including tax counseling, compliance plans and transactions to electronic medical records;
• Managing liability exposure in patient care decisions such as transfer, discharge and end-of-life decisions, through interpretation of insurance policies, regulations such as EMTALA, and hospital by-laws;
• Navigating billing issues, including counseling on issues such as prospective vs. cost-based payment, consolidated billing and managed care contracting agreements and dispute resolution with Medicare/Medicaid and private payors;
• Structuring physician employment and referral relationships compliant with state and federal laws such as Stark, anti-kickback and corporate practice of medicine doctrine including medical director agreements, professional service agreements and call coverage agreements;
• Protecting patients' privacy by developing practices that comply with state and federal privacy laws including HIPAA, responding to patient privacy complaints and assisting hospitals with their entire electronic information management platform;
• Resolving disputes with patients or other third parties and providers such as disputes over privacy issues, vendor disputes, employment contracts and other benefits;
• Conducting human subjects research in an academic setting and other settings consistent with federal regulations, privacy laws and ethical standards;
• Providing ongoing guidance related to the structure and operation of compliance programs;
• Providing ongoing regulatory compliance advice;
• Assisting with internal investigations and fraud and abuse defense;
• Advising on the creation of or revision, update and interpretation of Medical Staff Bylaws and related documents to comply with applicable Accreditation Standards and Medicare Conditions of Participation (COPs);
• Providing counseling on the Medical Staff Corrective Action and Fair Hearing process;
• Providing representation of the Hospital in any Fair Hearing and subsequent litigation filed by a Medical Staff member;
• Advising on physician recruitment issues and preparing physician recruitment agreements to comply with applicable federal law including Stark and the Anti-Kickback Statute;
• Providing advice related to licensing and permitting issues such as state licensing standards, pharmacy permit and other ancillary permit requirements;
• Advising on the provider enrollment process including updates of existing provider applications and new provider applications and obtaining National Provider Identifiers (NPIs);
• Managing the process for changes of ownership (CHOWs) with the various state and federal agencies including Medicare and DHEC;
• Providing guidance on survey issues based on state licensing and Medicare requirements and accreditation standards; and
• Providing ongoing operational advice including review and drafting of contracts, review and drafting of policies and procedures, and
• Addressing patient consent issues.