Healthcare Industry

At a time of rapid change and tremendous uncertainty within the healthcare industry, the BakerHostetler Healthcare Industry team has the national presence and depth to help our clients strategically navigate these challenges to manage and respond nimbly to change.

Team members have been senior managers with hospitals and health centers, research centers, health maintenance organizations and third-party providers, imbuing our team with an insider's perspective into challenges from credentialing to reimbursement, from privacy matters to regulatory compliance.

Complementing our deep healthcare experience, we leverage BakerHostetler’s more than 900 attorneys in 14 offices nationwide to counsel healthcare clients in multiple areas of law, including employment and labor, litigation, white collar and business practices, tax, government policy and intellectual property.

Our Clients

Our clients span the range of the hospital industry, physician practices, suppliers and pharmaceutical companies, long-term care, home health, hospice and specialized niche providers and venture capital entities operating in the healthcare sector. We hold a unique, national presence in the academic medical center, children’s hospital and data breach areas. We have counseled many of our clients for decades, including some of the nation’s leading medical facilities. They trust us to consider particular problems within the context of their broad business needs and to provide creative solutions.

Our Services

Clients look to our Healthcare Industry team to form new entities and ventures, respond to data breaches and other privacy matters, identify and advise on specific fraud and abuse risk areas, defend against enforcement investigations and proceedings and develop and execute legislative and regulatory strategies, among many other tasks.

We help hospitals, health systems, academic medical centers and other medical providers grow through acquisitions of facilities, facility leases, financings, management contracts, affiliate agreements and the creation of new relationships with relevant providers, and we counsel them on a full range of operational matters. We work 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. We have been deeply engaged in helping clients adapt to and capitalize on the Affordable Care Act, assisting in the development of initiatives including medical homes and accountable care organizations.

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Our Healthcare Privacy team continues to be on the cutting edge of HIPAA and HITECH and has provided timely and discrete advice to clients through more than 300 data breach responses, including responses to the three largest U.S. healthcare data breaches ever reported. We counsel healthcare providers and other covered entities on HIPAA and state privacy law compliance, breach response, crisis management and regulatory investigations and audits. We represent many of the nation's top academic medical centers, children’s hospitals and health systems on privacy issues.

In this period of aggressive regulatory enforcement, our enforcement and compliance attorneys work to keep our clients out of the headlines by proactively identifying and providing advice on their specific risk areas, including those related to the Anti-Kickback and Stark laws, the False Claims Act, HIPAA and HITECH, EMTALA, licensing and certification matters, OSHA and a wide range of coding and billing issues. Our team has substantial experience defending providers in all facets of audits and proceedings initiated by fiscal intermediaries, program integrity contractors and federal and state governmental authorities, among many others.

We have specialized healthcare reimbursement experience in Medicare and Medicaid program payment matters, having handled major reimbursement disputes in both Medicare and Medicaid graduate medical education (GME) and disproportionate share hospital (DSH) issues. We assist with Medicare and Medicaid appeals and audits, including from Recovery Audit Contractors (RAC), Zone Program Integrity Contractors (ZPIC), Medicaid Integrity Contractors, state OIG audits and other payors and audit contractors. We also represent hospitals and physicians in managed care negotiations, contracting, payment disputes and are experienced in the Medicare and Medicaid managed care law and regulations.

Our Healthcare Public Policy team leads industry coalitions and helps clients develop legislative and regulatory proposals concerning healthcare reform, reimbursement and transactional issues. We help clients effectively communicate with Capitol Hill and Administration policymakers, work with administrative agencies and deal with enforcement officials.

Select Experience

  • Served as team leader in a major integration of an academic medical center's faculty practice plans, including the transition of 450 physicians and more than 20 separate non-profit and for-profit entities. Established a plan for a new entity to function as the sole multi-specialty practice plan. Resolved governance, organizational, tax and regulatory issues.
  • Counseled a regional healthcare system in the wake of improper employee access to over 100,000 patients' records. Coordinated the internal investigation and led the response on several fronts, including crisis management, notification of affected patients, resolution of patient complaints, regulatory investigations and defense in a class action alleging failure to safeguard confidential personal information and notify class members of the incident in a timely manner. We combined our healthcare, privacy and class action litigation experience for a full-service strategic defense of the matter.
  • We provide the Children’s Hospital Association—which includes more than 200 children’s hospitals in this country—with national Medicaid policy advice. We helped to develop a particular program for children with chronic and complex conditions, develop a risk-based payment mechanism in Medicaid tied to the creation of a pediatric medical home and analyzed Medicaid claims data and whether a coordinated care model can provide scoreable savings for Congress. We are directly involved in both the continued development of the policy, as well as with strategic advocacy in Congress, with CMS and the administration, identifying champions, preparing and supporting the policy, developing the legislative language and providing substantive legal and policy support for the concept.
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Professionals

Name Title Office Email
Darby C. Allen Associate Houston
M.J. Asensio Partner Columbus
G. Thomas Ball Partner Orlando
Jonathan R. Barr Partner Washington, D.C.
S. Derek Bauer Partner Atlanta
Edward J. Beckwith Partner Washington, D.C.
Jeffrey P. Berg Partner Los Angeles
Kameron L. Brackins Associate Houston
Kevin D. Bradberry Associate Atlanta
Ian K. Byrnside Partner Atlanta
Matthew W. Caligur Partner Houston
Thomas S. Campanella Of Counsel Cleveland
Jessica Captain Novick Partner Orlando
John J. Carney Partner New York
Donna S. Clark Partner Houston
Clayton W. Coley Partner Atlanta
Charlotte A. Combre Partner Atlanta
Christopher L. Cottrell Jr. Associate Atlanta
Payal P. Cramer Associate Atlanta
Emily C. Crosby Partner Atlanta
Steven M. Dettelbach Partner Cleveland
Vimala Devassy Counsel Atlanta
Rodger L. Eckelberry Partner Columbus
Joseph E. Ezzie Partner Columbus
Eric R. Fish Partner New York
Stephen M. Floyd Associate Atlanta
Elizabeth Price Foley Of Counsel Washington, D.C.
Amy E. Fouts Partner Atlanta
Alan L. Friel Partner Los Angeles
Lynn S. Garson Counsel Atlanta
Elizabeth A. Green Partner Orlando
Kyle R. Gregory Associate Atlanta
Susan Feigin Harris Partner Houston
Mark Hatcher Partner Columbus
Lori A. Herf Senior Advisor Columbus
Scott C. Holbrook Partner Cleveland
Lindsay P. Holmes Associate Washington, D.C.
Susan Whittaker Hughes Associate Cleveland
Christian B. Jones Senior Advisor Washington, D.C.
Joann Gallagher Jones Partner Atlanta
Thomas W. Kahle Partner Cincinnati
Laura R. Kaufman Associate Washington, D.C.
Shannon A. Kidwell Counsel Atlanta
Richard M. Knoth Partner Cleveland
Theodore J. Kobus III Partner New York
Laurice Rutledge Lambert Associate Atlanta
Jerry R. Linscott Partner Orlando
C. Dennis Loomis Partner Los Angeles
Raymond M. Malone Partner Cleveland
Wendy W. Markham Partner Atlanta
Lori P. Markley Regulatory Analyst Atlanta
Michael R. Matthias Partner Los Angeles
B. Scott McBride Partner Houston
Charlene L. McGinty Partner Atlanta
John J. McGowan Jr. Partner Cleveland
M. Scott McIntyre Partner Cincinnati
Michael W. Mengis Partner Houston
Sameer V. Mohan Partner Houston
James R. Morrison Associate Seattle
Kristi K. North Associate Atlanta
Banee Pachuca Associate Houston
Eric A. Packel Partner Philadelphia
Francis B. Palumbo Of Counsel Washington, D.C.
John W. Petrelli III Partner Houston
Lenard I. Pick Partner Los Angeles
James C. Rawls Partner Atlanta
Lauren J. Resnick Partner New York
Lee H. Rosebush Partner Washington, D.C.
Noah D. Rosenberg Partner Los Angeles
Robert M. Rozier Partner Atlanta
Kimberly S. Ruark Counsel Atlanta
Kathleen P. Rubinstein Healthcare Policy Analyst Houston
Robert K. Rupp Partner Columbus
Gregory S. Saikin Partner Houston
David L. Schick J.D., LL.M. Partner Orlando
Edmund W. Searby Partner Cleveland
Lynn Sessions Partner Houston
Lance L. Shea M.S., J.D. Partner Washington, D.C.
Lee H. Simowitz Partner Washington, D.C.
Summer D. Swallow Associate Houston
Christopher J. Swift Partner Cleveland
Paulette M. Thomas Counsel Cincinnati
Tyler M. Thompson Senior Advisor Washington, D.C.
Amy J. Traub Partner New York
Gary A. Wadman Partner Columbus
Daniel R. Warren Partner Cleveland
Leah Fressell Watkins Regulatory Analyst Atlanta
Robert C. Welsh Of Counsel Los Angeles
Jennifer P. Whitton Associate Atlanta
Alec Wightman Partner Columbus
Lauren Wright Wilson Counsel Los Angeles
Robert M. Wolin Partner Houston
Kristen McDermott Woodrum Partner Atlanta

Experience

  • Served as team leader in a major integration of an academic medical center's faculty practice plans, including the transition of 450 physicians and more than 20 separate non-profit and for-profit entities. Established a plan for a new entity to function as the sole multi-specialty practice plan. Resolved governance, organizational, tax and regulatory issues.
  • Counseled a regional healthcare system in the wake of improper employee access to over 100,000 patients' records. Coordinated the internal investigation and led the response on several fronts, including crisis management, notification of affected patients, resolution of patient complaints, regulatory investigations and defense in a class action alleging failure to safeguard confidential personal information and notify class members of the incident in a timely manner. We combined our healthcare, privacy and class action litigation experience for a full-service strategic defense of the matter.
  • We provide the Children’s Hospital Association—which includes more than 200 children’s hospitals in this country—with national Medicaid policy advice. We helped to develop a particular program for children with chronic and complex conditions, develop a risk-based payment mechanism in Medicaid tied to the creation of a pediatric medical home and analyzed Medicaid claims data and whether a coordinated care model can provide scoreable savings for Congress. We are directly involved in both the continued development of the policy, as well as with strategic advocacy in Congress, with CMS and the administration, identifying champions, preparing and supporting the policy, developing the legislative language and providing substantive legal and policy support for the concept.
  • Representing major children’s hospitals in Texas and Washington state in challenging a CMS interpretation of the DSH hospital specific limit (HSL) reimbursement relative to the calculation of Medicaid shortfall. Similar determinations affect all seven freestanding children’s hospitals in Texas for a total potential loss of as much as $70 million in Medicaid program reimbursement and approximately $15 million to Washington children’s hospitals. Representation involves meeting with CMS officials, convincing the State of Texas to support a compromise approach, developing federal legislative bill language and support of the Texas and Washington delegation and filing a temporary restraining order in state court.

Recognition

  • Chambers USA: Healthcare
    • Georgia (2015, 2016)
    • Ohio (2011 to 2016)
    • Texas (2009 to 2016)
  • BTI Client Service 30: BakerHostetler advanced 19 positions to #9 (2016)
  • U.S. News - Best Lawyers “Best Law Firms” (2016)
    • Health Care Law
      • National Tier 1
      • Metro Atlanta, Tier 1
      • Metro Cincinnati, Tier 2
      • Metro Cleveland, Tier 2
      • Metro Columbus, Tier 2
      • Metro Houston, Tier 1
  • The Best Lawyers in America© (2016)
    • 10 lawyers named in Health Care Law
  • Named a national leader among law firms serving the healthcare industry by the BTI Client Relationship Scorecard 2014: Ranking Law Firm Client Relationships

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In The Blogs

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Health Law Update
CMS Finalizes Mandatory Cardiac and Joint Bundles … But Their Future is Uncertain
January 17, 2017
When Tom Price assumes the top post at the U.S. Department of Health and Human Services (HHS) later this month (subject to Senate confirmation), the ink will barely be dry on a final rule issued by the Centers for Medicare & Medicaid...
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Health Law Update
Human Drug Compounding: FDA Issues Four Guidance Documents
January 16, 2017
FDA had a busy holiday season, issuing two final guidance documents and two draft guidance documents for industry related to human drug compounding right before the start of the new year. These guidance documents cover prescription...
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Health Law Update
January 18, 2017 Webinar: What to Expect in Trump’s First 100 Days
January 13, 2017
After years of gridlock, Congress is poised to unleash a flurry of legislative activity early in 2017. The agenda is jam-packed as the Republican-led Congress targets major changes to the Affordable Care Act, Dodd-Frank, taxes and a host...
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Health Law Update
Capitol Hill Healthcare Update
January 10, 2017
A growing number of moderate and conservative Republicans in Congress are voicing concerns about the party’s strategy to repeal the Affordable Care Act (Act) in February but then wait months – and possibly even into 2018 – before...
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Health Law Update
Capitol Hill Healthcare Update
January 4, 2017
New Congress targets ACA repeal Republican congressional leaders overseeing the new 115th Congress will trigger a legislative process this week which will likely culminate in February with the repeal of most of the Affordable Care Act...
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Healthcare Highlights: 25th Annual Legislative Seminar