Practice Strengths

BakerHostetler provides healthcare organizations with comprehensive legal counsel as they navigate today’s complex and rapidly changing industry environment. Our industry-focused team draws on the firmwide capabilities of colleagues in business, employment and labor, litigation, white collar and business practices, tax, government policy and intellectual property, among other areas.

Team members have been senior managers with hospitals and health centers, research centers, health maintenance organizations and third-party providers, providing our team with practical insight into important issues from credentialing to reimbursement, from privacy matters to regulatory compliance. With that knowledge, we deliver highly efficient and effective legal services to hospitals, academic medical centers, physician groups and suppliers of healthcare-related goods as they face new marketplace challenges, manage operational issues and work toward their strategic goals.

With a national platform and offices coast to coast, BakerHostetler features one of the largest, most experienced healthcare practices in the United States. Our team was listed among the top Texas and Ohio healthcare practices in the latest edition of Chambers USA.

Our Clients

• For-profit and not-for-profit hospitals, health systems and academic medical centers
• Physicians and medical staff
• Physician groups
• Specialty physician organizations
• Dental practices
• Ancillary service providers (including dialysis, home health, durable medical equipment, etc.)
• Long-term care providers
• Suppliers and pharmaceutical companies
• Professional services providers
• Venture capital entities operating in the healthcare sector

Our Services

BakerHostetler Healthcare team members are intimately familiar with the Affordable Care Act, and we actively assist our provider clients in the development of related initiatives, including medical homes and accountable care organizations. We also counsel hospitals, health systems and academic medical centers on a full range of their operational matters, and we assist them with business growth through the acquisition of facilities, financings and creation of new relationships with relevant providers.

Our team further works with physician groups of all sizes to structure joint ventures and other relationships between and among physicians, physician groups, hospitals, special healthcare service providers and others in the industry.

As the healthcare industry continues to see unprecedented regulatory enforcement and even criminalization of activity, BakerHostetler helps clients minimize the legal risks in regulatory compliance activities, including fraud and abuse, Stark, anti-kickback, and false claims compliance. We work with boards, compliance committees and officers on the changing needs and requirements of industry compliance. We also represent clients in False Claims Act litigation as well as other enforcement proceedings.

We work closely with our government policy attorneys and advisors, combining efforts and experience to provide the highest level of service to healthcare industry clients facing federal legislative, regulatory and enforcement issues. Our Healthcare Public Policy team focuses on healthcare transactions, Stark and anti-kickback laws, Medicare and Medicaid reimbursement issues, healthcare reform issues, tax-exempt industry reform and issues relating to the uninsured. They develop solutions by communicating with Capitol Hill and Administration policymakers, working with administrative agencies and dealing with enforcement officials.

Members of the BakerHostetler Healthcare team routinely offer counsel with respect to HIPAA and HITECH regulations, and our attorneys advise on issues related to data security, including risk management, regulatory compliance, breach response strategies and litigation defense.

Transactional

• Counsel on restructuring transactions, including acquisitions, sales, affiliations, joint operating arrangements, joint ventures and mergers, including those that involve combinations of for-profit and not-for-profit operations.
• Structure not-for-profit and for-profit joint ventures between and among physicians, physician groups, hospitals and special healthcare service providers in the industry.
• Provide bond, underwriter, borrower and trustee counsel in billions of dollars of financings.
• Advise providers on reorganizations designed to align business interests, minimize corporate income taxes, reduce state and local taxes and unrelated business income tax exposure, and minimize risk of revocation of tax exempt status.
• Help physician clients establish alternative structures, including management service organizations, accountable care organizations, physician hospital organizations, integrated provider networks and disease management centers of excellence.

Operational

• Provide guidance on programs and initiatives designed to align with the Affordable Care Act.
• Advise clients on licensure, accreditation matters, affiliation agreements, compensation models and research requirements.
• Represent provider clients and their staff in medical malpractice, wrongful death and premises liability matters, providing successful defense in courts throughout the U.S., and limiting malpractice exposure through effective risk management and peer review programs.
• Counsel on a full range of general and specialized labor and employment issues: background investigations, discrimination cases, wage and hour issues, OSHA and safety compliance issues, union organization and bargaining issues, benefit and pension matters, medical staff review board and peer review proceedings, and physician contracting matters.

Reimbursement and Managed Care

• Manage issues that arise in the relationship between healthcare providers and managed care organizations, including negotiation of fees, claims adjudication, termination, contract reviews and breach of contract actions.
• Assist with cost reporting and billing compliance, national Medicare coverage determinations, local medical review decisions, certification matters and the special issues related to PPS-exempt providers, including children’s hospitals
• Enroll providers in governmental payment programs throughout the United States.

Enforcement and Compliance

• Help clients establish and implement corporate compliance programs.
• Provide guidance on reimbursement requirements related to graduate medical education programs.
• Counsel clients on research compliance matters.
• Assist clients faced with Medicare and Medicaid appeals and audits, including from Recovery Audit Contractors (RAC), Zone Program Integrity Contractors (ZPIC) and other payors and audit contractors.
• Represent healthcare clients in False Claims Act litigation and investigations.
• Conduct internal investigations, including self-disclosures and corrective action.
• Advise clients on Stark, anti-kickback, civil monetary penalty and fraud and abuse matters.
• Defend clients in HIPAA, OSHA, EMTALA, Stark, fraud and abuse, and Medicare/Medicaid matters.
• Guide clients through government audits and investigations.
• Represent clients in administrative and federal court actions related to overpayment demands and reimbursement actions.

Policy

• Represent healthcare clients before Congress, the Administration and healthcare regulatory agencies.
• Provide proactive advocacy on reimbursement and health policy issues.
• Assist in the creation of government relations strategies and outreach efforts.
• Develop legislation for Congress.

Privacy and Data Security

• Counsel clients on HIPAA (Health Insurance Portability and Accountability Act) privacy regulations, the Health Information Technology for Economic and Clinical Health (HITECH) Act and state privacy laws.
• Develop comprehensive privacy and security programs to comply with HIPAA, HITECH and state regulations.
• Guide clients through data breach crisis management, investigation, notification and follow-up actions – including litigation defense.

Additional Capabilities

• Advise the medical departments of non-healthcare industry clients on matters related to disaster preparation.
• Represent global producers and distributors of pharmaceuticals in connection with product distribution, group purchasing organization agreements, manufacturer representation agreements, antitrust and product liability matters.

Recognition

• Listed among the top Texas and Ohio healthcare practices in the latest edition of Chambers USA.
• Four Houston partners and a Cincinnati partner listed in Chambers USA as being leaders in healthcare law.  
• BakerHostetler’s Healthcare practice received a National Tier 2 Ranking from The Best Lawyers in America® 2013 edition (Copyright 2012 by Woodward/White, Inc., of Aiken, S.C.), and was ranked in Tier 1 among healthcare practices in Houston and Cleveland, and Tier 3 among healthcare practices in Cincinnati
• Six national Healthcare team members listed as being leading practitioners in the latest edition of Best Lawyers in America.