Healthcare

The Schnader Advantage

Schnader attorneys are experienced in all areas of health law and are active in tracking new legal development. Our clients receive experienced counsel from senior practitioners – fast, cost-effective representation. Our lawyers counsel clients in every business and regulatory aspect of health law, and have wide practical experience in the issues confronting health care professionals in Pittsburgh, Philadelphia, New York, Washington, D.C., and other major markets. Our practitioners sit on hospital boards and audit committees and, in those roles, have come to understand the business of health care.

Scope of Work

Health care delivery is a strong financial driver of the local, state and national economy. We represent health care systems, hospitals, continuing care retirement communities, outpatient centers, physician groups, clinical laboratories, physician hospital organizations, other health care professionals, management organizations, pharmaceutical and biotech companies and distributors, managed care organizations, and medical supply and service providers. In today’s health care environment, the face of care is changing to expanded outpatient, pharmacological and technological treatment. Caring for an aging population is a major factor in acute and long-term care settings. Our attorneys stay abreast of recent developments and trends to assist our clients in realizing their goals.

The Health Law Practice Group consists of attorneys who concentrate on the unique legal issues of the health care industry. Attorneys in the group employ a multidisciplinary approach to meet our clients’ needs. Our health care practice currently handles matters in the following areas:

• Corporate planning and structure
• Regulatory compliance
• HIPAA and medical records privacy
• Contracts
• Hospital-physician relations
• Mergers, acquisitions and affiliations
• Medical staff issues
• Fraud investigations and defense
• Medicare, Medicaid and third-party payment
• Tax, tax exemptions and tax-exempt finance
• Joint ventures
• Licensure and credentialing
• Antitrust
• Managed care
• Employee and labor relations
• Employee benefits
• Real estate and asset acquisitions
• E-health and health care technology
• Mental health
• Patient care
• Creditors’ rights and bankruptcy
• Technology transfer, intellectual property and licensing
• Fundraising and endowments
• Environmental and occupational regulations

Corporate Planning and Structure

We have planned hospital and health care system reorganizations and have assisted in the development of innovative corporate structures and alternative delivery systems. We assist clients in the establishment of appropriate entity structures, including limited liability companies, nonprofit corporations and medical foundations. For closely held businesses, we prepare employment and buy-sell agreements and develop compensation plans.

Regulatory Compliance

We help our health care clients comply with a multitude of regulatory requirements including fraud and abuse laws, Stark and other physician self-referral laws, the False Claims Act and the OIG Compliance Program Guidelines. The federal Stark and Anti-Kickback Laws and their state law counterparts place significant restrictions on the ability of health care providers to engage in activities that involve the referral of patients for services. Our attorneys are highly experienced in structuring arrangements to comply with these laws while affording physicians and group practices the flexibility to meet their business objectives.

HIPAA and Medical Records Privacy

We advise clients regarding the health information privacy and patient access requirements mandated by the Health Insurance Portability and Accountability Act of 1996 and state law counterparts, including assisting in the design and implementation of compliance programs, preparing and amending privacy notices and plan documents, drafting and reviewing business associate agreements, and developing policies for responding to subpoenas and third-party requests for protected health information.

Contracts

We provide comprehensive services that include contract negotiations for various types of arrangements for health care providers with special emphasis on recruitment guarantees, practice plans, employment, faculty appointments and exclusive arrangements.

Hospital-Physician Relations

We represent hospitals, health care networks, ambulatory health care facilities and physicians in contractual issues and with respect to the overall relationships between such institutions and their physicians. This may involve issues including payment, staffing and credentialing.

Mergers, Acquisitions and Affiliations

We provide regulatory, business and legal counsel for mergers, acquisitions and affiliations involving a variety of health care organizations, including hospitals, health systems, skilled nursing facilities, continuing care retirement communities and home health agencies. We have strong capabilities in the acquisition and sale of physician practices and free-standing providers for the building of integrated systems. We have represented nonprofit hospitals selling assets to for-profit organizations and are conversant with the special issues involved in regulatory, attorney general and judicial review of such transactions.

Medical Staff Activities and Bylaws

We advise clients concerning the interpretation and compliance of their corporate and medical staff bylaws with accreditation guidelines, state requirements and the applicability of various anti-discrimination laws. We represent clients in disputes involving physicians alleging the improper denial of staff privileges or termination of employment.

Fraud Investigations and Defense

Billing and payment investigations, investigations of compliance with various laws and the pursuit of repayment for alleged irregularities are becoming commonplace. At times, criminal or civil litigation is brought against institutions, organizations or individuals. Our attorneys are especially familiar with the defense of such cases, some of which have been successfully defended through trial.

Medicare, Medicaid and Third-Party Payment

Attorneys in our Health Law Practice Group provide guidance on interpreting reimbursement rules under federal and state programs and from other third-party payors. When necessary, we represent clients in payment disputes, litigate appeals and enforce prompt payment obligations. We advise clients on all aspects of third-party contracts including negotiations, arbitration, appeals and litigation arising from contractual disputes.

Tax, Tax Exemptions and Tax-Exempt Finance

Although most hospitals and systems are tax-exempt entities, many have taxable affiliates or seek to participate in ventures that raise issues that affect tax exemption and unrelated business income. Local tax exemption is also a significant part of our practice. Our attorneys are experienced in taxable and tax-exempt financing arrangements for all types of healthcare providers. We are also recognized bond counsel to the tax-exempt bond market. We assist our clients in structuring relationships necessary to gain access to capital markets.

Joint Ventures

We provide counsel in connection with the formation of joint ventures between and among many types of entities. We assist clients in developing joint ventures with groups of organizations as a means of acquiring and operating major medical equipment and implementing new health care services.

Licensure and Credentialing

We advise clients regarding the applicability of licensing regulations to equipment and building projects, and to specific services such as ambulatory care facilities, MRI services, rehabilitation services and nursing homes. We counsel clients on matters relating to peer review and other credentialing issues.

Antitrust

We advise clients about the possible anti-competitive effects of joint negotiations, mergers, affiliations, reorganizations, joint ventures, the formation of physician groups and exclusive arrangements. When necessary, we litigate antitrust and anti-competitive issues.

Managed Care

Today’s payment-driven health delivery system requires a thorough understanding of contracting issues involving managed care organizations. We have experience in representing all segments of providers with managed care organizations.

Employee and Labor Relations, Including Employee Benefits

We represent many employers in labor and employment matters including relations with union and nonunion employees. These matters typically include opposing union organizational campaigns, providing counsel on dealing with union activity, representing providers in collective bargaining negotiations with unions, and handling workers’ and unemployment compensation matters. We represent employers in all areas of equal employment opportunity law. We handle compliance with state employment legislation including statutes governing family leave, wage payment and withholding laws, and AIDS. Our employee benefits lawyers assist in the design and implementation of tax-qualified pension and profit-sharing plans. We have developed specialized retirement benefit arrangements for nonprofit employers.

Real Estate and Asset Acquisition

Our real estate services for health care clients include advising clients about the impact of environmental regulations, drafting and reviewing leases, negotiating and preparing contracts for purchase or sale and other related documents, and advising clients about how to comply with laws about accessibility for disabled persons. Further, with many municipal and state governments imposing taxes on nonprofit organizations, we provide counseling on and appeals of such decisions.

E-Health and Health Care Technology

Our attorneys are participants in a leadership role in the emerging areas of the Internet, computerized patient records and telemedicine, developing policies for public interest and industry groups, and assisting clients in the assessment of the legal risks and compliance with appropriate laws, including such issues as professional licensure across state lines and confidentiality and security.

Mental Health

Mental health and substance abuse are specialty health care areas. Our attorneys advise clients on the special licensing, payment issues, programs and confidentiality issues that arise in such settings.

Patient Care

We counsel clients about evolving areas of the law such as informed consent, treatment and discharge of incompetent patients, right to refuse life-sustaining treatment, medical records, advance directives, determination of incompetency, guardianships, donating organs, AIDS and the determination of death.

Creditors’ Rights and Bankruptcy

The special risks inherent in dealing with insolvent or bankrupt entities are assisted by our creditors’ rights attorneys. They handle litigation, structure transactions and represent our creditor and debtor clients in the bankruptcy and reorganization process.

Technology Transfer, Intellectual Property and Licensing

Our intellectual property attorneys handle patents, trademarks and copyrights. They also assist with licensing of rights to third parties and in other technology transfers and ventures.

Fundraising and Endowments

Our attorneys provide advice with respect to gift and donor programs for charitable institutions, foundations and trusts. Advice is given with respect to permitted investments, utilization of restricted funds and representation in probate courts when necessary in the jurisdictions where we practice.

Environmental and Occupational Regulations

Schnader’s environmental lawyers help health care providers understand and comply with the plethora of regulations that govern the disposal of medical wastes. During the solid waste and air-permitting processes, we counsel such organizations and frequently work with their engineering consultants. We also counsel many organizations about how to limit their liability from the risks associated with environmental conditions, and assist them with public and community relations during citizen intervention in the permitting process.

Our Lawyers

Our Firm’s health care lawyers are active in bar and health law organizations including the American Health Lawyers Association. Our attorneys lecture frequently and contribute regularly to health industry publications. Several of our attorneys are involved in initiatives to advance new technologies and other public policies.