Hospitals and Health Systems

Overview

Hospitals and health systems face a daunting challenge: They must continue diversifying their business lines to take advantage of new technologies and meet community needs while establishing effective physician recruitment and integration strategies and operating within an extremely difficult financial environment.

As a health care “super boutique,” Epstein Becker Green has significant experience representing tax-exempt and for-profit health systems and community hospitals in a wide variety of regulatory, operational, and strategic business issues and helping them overcome their challenges. We are fully familiar with the increasingly vigilant government enforcement climate, which defines the health care industry's modern environment.

Our approach to representing hospitals and health systems involves a coordinated synergy among lawyers with experience in all relevant subject matters, including corporate law, tax-exempt law, fraud and abuse, hospital law, litigation, biomedical and human subject research, managed care, and employment law.

Since the early 1980s, we have represented hundreds of hospitals and health systems as general counsel and in specific projects. We have been at the forefront of physician-hospital integration and alignment efforts, as well as in the consolidation of health care systems, both in corporate structuring and in obtaining antitrust clearance. We have represented hospital systems in hundreds of mergers, acquisitions, and joint ventures and have successfully defended several highly visible government challenges to hospital mergers. Clients rely on us to advise them in connection with establishing ancillary service joint ventures, such as ambulatory surgery centers (ASCs).

Our Services

Drawing on our vast knowledge in a range of legal subjects, Epstein Becker Green provides complete legal support for hospitals and health systems in connection with their transactional, regulatory, and strategic initiatives. Our services include, among other things:

Providing corporate representation (including antitrust counseling) in connection with transactions, such as mergers, acquisitions, joint ventures, and divestitures
Supplying regulatory counseling on fraud and abuse, the Stark Law, and state regulatory compliance issues in transactions and other physician-integration arrangements
Providing guidance in connection with strategic initiatives on creating more integrated delivery systems, as well as structuring and negotiating joint ventures and agreements with a variety of third parties, including other health care providers, administrative service providers, and other vendors, to create integrated delivery systems
Synthesizing tax-exempt law requirements with fraud and abuse rules in hospital-physician arrangements and joint ventures
Seeking Advisory Opinions from federal regulatory agencies in appropriate cases
Counseling on labor and employment issues
Advising on HIPAA compliance
Counseling on Medicare and Medicaid (and other government health programs) compliance activities, including internal investigations of potential noncompliance; responding to government inquiries and investigations; advising on voluntary disclosures; and negotiating corporate integrity agreements (CIAs)
Advising on EMTALA compliance
Structuring and negotiating appropriate compensation arrangements with physicians in connection with employment, medical directorships, recruitment initiatives, department management, and office and equipment leases
Structuring and negotiating physician practice acquisitions and divestitures
Establishing and implementing corporate compliance programs for hospital and ancillary providers within the health system
Addressing medical staff matters, including fair hearing requirements and designing state-of-the-art medical staff bylaws
Negotiating managed care agreements and risk-sharing arrangements with payors
Providing guidance in connection with strategic initiatives on system affiliations