HEALTH & HUMAN SERVICES

• HEALTH LAW ALERTS

Influential and Dynamic Advocates
We are leaders and innovators in one of the most sophisticated and demanding markets in the country. Our extensive industry knowledge helps give our health care and human service provider clients an edge in regulatory matters, complex transactions and enforcement actions.

Longstanding Relationships
As one of the area’s premier health law groups, we have played a central role in strengthening the base of providers in the region who are working vigorously to further their missions. We forge long-term relationships with our clients, advising them from start up through growth and repositioning, business combinations and transfers, and restructurings and dispositions.

Attractive Fee Structure
We recognize that to succeed in the face of complex financial and legal challenges, our communities’ most vital institutions must have access to the highest caliber legal talent within a reasonable fee structure. We offer a rate structure to our nonprofit clients that enables them to obtain the services of our experienced lawyers for less than they would pay for junior associates at many other firms.

Extensive Range of Clients and Services
Our clients are key players in the health and human services business sector including:

• Hospitals and health systems (AMCs, teaching, community, specialty (LTCH, IRF, psych, and pediatric))
• Long-term care and assisted living
• CCRCs and supportive senior housing
• Community health centers
• Behavioral health organizations (mental health and substance use disorder services)
• Trade associations
• Home health, hospice and home care
• Clinically integrated networks (including ACOs, MSOs and MassHealth community partners)
• Physicians and allied health professionals
• Special education and early childhood providers
• Adult day health, adult foster care and day habilitation
• Ambulatory Surgery Centers, Clinics and Imaging Providers
• Industry vendors and consultants

We practice regularly before federal and state government bodies including the United States Department of Health and Human Services (HHS) Office of Inspector General (OIG) and Office of Civil Rights (OCR), the United States Attorney’s Office, the Centers for Medicare and Medicaid Services and MassHealth (including their administrative contractors and auditors), the Massachusetts Attorney General’s Office, the Massachusetts State Auditor, the Massachusetts Executive Offices of Health and Human Services and Elder Affairs, the Massachusetts Departments of Public Health, Mental Health, Development Services, and Children and Families, the Massachusetts Health Policy Commission, the Massachusetts Board of Registration in Medicine and other professional licensing boards, among others.

We provide comprehensive representation, bringing together nonprofit tax, tax-exempt bond finance, tax credit finance, commercial finance, civil litigation, real estate, and employment expertise with our industry knowledge to address regulatory, business, financial, transactional and operational challenges effectively.

Major practice focuses include:

Transactional – Negotiating transactional documents, performing due diligence, obtaining regulatory approvals and closing acquisitions and dispositions of assets including purchases, sales, mergers, affiliations, joint ventures and other transfers, as well as project financing.

Compliance – Advice as to the following:

• Licensure and certification standards of Medicare, Medicaid and other federal and state agencies
• Managed care contracting, billing and reimbursement, repayment issues and self-disclosure
• Ensuring compliance for tax exempt organizations (excess benefits) and state laws regarding public charities (cy pres, deviation and Beede petitions)
• Compliance with Department of Public Health determination of need (DoN) and plan approval requirements in connection with (i) changes of ownership; (ii) build-out of space for new or expanded services; or (iii) upgrading/acquiring of new technology (e.g., linear accelerators, PET scans, etc.)
• Drafting and reviewing of vendor services and employment contracts, management agreements and leases for compliance with fraud and abuse laws (anti-kickback, Stark) and payer regulations
• Surveys, audits and investigations; plans of correction; informal dispute resolution, and administrative appeals (including HHS Departmental Appeals Board)
• Privacy, data security and confidentiality (HIPAA, Part 2, and state law); data use agreements; breach investigation and reporting
• Medical peer review, professional licensing, discipline and reporting
• Public procurement and contracting

Corporate and Governance – Establishing and restructuring corporations and limited liability companies including drafting and amending articles of organization, by-laws, operating agreements, applications for tax-exemption and corporate policies and procedures. Advising as to governance matters such as conflicts of interest and fiduciary duties.

Capital Formation – Obtaining tax-exempt bond financing, conventional financing, REIT financing, and New Markets Tax Credits Financing.

Public Policy Matters and Innovative Programs – Serving as industry expert engaged by governmental agencies (licensing authorities and Attorney General). Representing trade groups in government stakeholder workgroups, commenting on proposed regulations and subregulatory guidelines, and drafting legislation. Establishing clinical affiliations and integration of health care services (e.g. primary and behavioral health, mobile care delivery). Assisting new care models as well as unique or vulnerable providers obtain special project approvals or waivers.

Distressed Entities – Assisting financially distressed health and human service providers in obtaining relief through legislative and regulatory strategies and impact litigation. Serving as court-appointed patient care receiver of long-term care facilities and as consultant to Attorney General.