Ulmer & Berne’s health care lawyers work together as a team to ensure that our health care clients achieve their overarching business objectives while simultaneously complying with the vast and continuously changing federal and state health care regulations.
Our health care attorneys are passionate about health law and providing each of our clients with access to the legal services necessary to succeed in this highly-regulated, competitive industry. We understand the business aspects of our health law clients and provide guidance on applicable laws and regulations, increasing their profitability, and growing their businesses.
We represent a wide-variety of health care clients, including: hospitals; health systems; retail pharmacies; single and multi-specialty physician groups; emergency and hospitalist staffing companies; long-term care providers, including skilled nursing and assisted living facility owners and operators; billing companies; preferred provider organizations; management service organizations; physician hospital organizations; clinics; nursing homes; pharmaceutical and durable medical equipment suppliers; and other entities.
Our depth of health care knowledge and experience is tremendous. On a daily basis, we provide clients with guidance on sophisticated and challenging mergers and acquisitions, investments, joint ventures, and other business relationships to ensure that they are structured and operationalized in accordance with federal and state Stark and other physician self-referral laws, anti-kickback laws, false claims laws, civil monetary penalty laws, and other fraud and abuse regulations.
For example, we frequently counsel our clients regarding health care financing, health care investments, issues related to tax exemption, corporate governance, physician and executive compensation, medical device and vendor contracting, third-party payor contracts and reimbursement, and managed care contracts.
Ulmer attorneys represent health care provider employers, shareholders, and employees in negotiating employment agreements, shareholder agreements, personal service agreements, management agreements, license agreements, distributorship agreements, and corporate governance documents related to health care. In addition, we represent clients on HIPAA and other federal and state privacy rules, data security, EMTALA, and medical staff litigation and disputes.
We also have substantial experience in counseling our clients in connection with health care payment and delivery reform, the Medicare Conditions of Participation, and other reimbursement issues, including audits, claim denials, reassignment issues, medical necessity determinations, and payor-contract negotiations.
Our health care practice lawyers frequently collaborate with our lawyers specializing in antitrust, business counseling and transactions, tax, litigation, labor and employment, employee benefits, white collar crime, and cybersecurity to provide high-quality, efficient services to our clients in a timely manner. Providing excellent client service is our priority.
April 27, 2021 – The U.S. Department of Health and Human Services (HHS) Office for Civil Rights in Action (OCR) is responsible for enforcement of HIPAA privacy and security regulations, and was recently made aware of fraudulent postcards being sent to health care organizations. While the “risk analysis” mentioned in...
May 27, 2021
The Centers for Medicare & Medicaid Services (CMS) and the Department of Health and Human Services Office of the Inspector General (OIG) issued two highly anticipated (and extensive) final rules to reform the Stark Law and Anti-Kickback Statute (AKS) regulations. These rule changes and clarifications are aimed at removing regulatory...
November 23, 2020
In an article from Bloomberg Law, Ulmer attorneys Daniel Gottesman and David Schweighoefer are quoted discussing the mounting coronavirus infections and deaths at U.S. nursing homes and the potential for law suits that could follow. According to the article, more than 10,000 nursing home residents and staff members have died...
April 28, 2020
In recent weeks, the U.S. Department of Justice has sharply increased scrutiny of owners and operators of long-term care facilities and nursing homes. On March 3, 2020, Attorney General William Barr announced the “DOJ’s National Nursing Home Initiative,” which will “coordinate and enhance civil and criminal efforts to pursue nursing...
April 24, 2020
Ulmer & Berne LLP is proud to announce the addition of Counsel David E. Schweighoefer to its Cleveland office where he joins the firm’s respected Health Care Practice Group. For the past 30 years, Schweighoefer has provided advice to a wide array of health care providers helping them achieve their overarching business...
November 18, 2019
Additions to Business Litigation and Health Care Practice Groups Ulmer & Berne LLP is pleased to announce the addition of two talented and experienced attorneys to the firm. Counsel Shawn J. Gebhardt joins the Business Litigation Practice Group and Associate Ellesha M. LeCluyse joins the Health Care Practice Group. These additions continue Ulmer’s commitment...
September 07, 2018
In today’s environment, where cybersecurity threats are becoming more and more pervasive, even small health care organizations understand that purporting to have comprehensive data privacy and security policies and procedures in place isn’t enough. Business partners want more. Regulators demand more. They want implementation and efficacy. They want to know...
September 19, 2017
As many professionals and business owners are well aware, there is often a tension between what is best from a business development perspective and what is best from a legal perspective. This is certainly true when it comes to submitting RFP responses. Businesses should generally pause for a moment before...
August 15, 2017
Stephanie Trudeau is speaking this week at the Northern Ohio Labor and Employment Law Conference on the topic of “Medical Marijuana in the Ohio Workplace”. Her presentation covers the conflict between Ohio’s statute legalizing marijuana and federal law criminalizing it, suggested policies and practices for employers, and possible scenarios for lawyers to...
April 19, 2017
It is more important than ever to have an effective internal corporate compliance program tailored to your organization’s compliance risks. Funding for federal government efforts to fight health care fraud is likely to go up, not down. In February and March, federal agencies issued important new guidance on their enforcement...
April 04, 2017
Could any of the following happen in your workplace? An unencrypted laptop with patient information is lost or stolen An unauthorized person accesses a computer database with patient information Patient billing records are left in an unsecured trash bin in a location with public access A hacker accesses patient information...
February 08, 2017
Partner Jennifer Lawry Adams has been named to the Leadership Cleveland Class of 2017. Ms. Adams is among just a handful established leaders who have been selected from a highly competitive pool by The Cleveland Leadership Center. Leadership Cleveland is a leadership development and civic engagement program that empowers recognized,...
July 13, 2016
The health care industry needs to proactively respond to an emerging data security threat. Hackers are not only stealing personal information from health care organizations for resale but are also beginning to shut down health care organizations’ operations using ransomware. Ransomware is a type of malware that encrypts a victim’s...
April 28, 2016
In March, the Office of Civil Rights (OCR) of the U.S. Department of Health and Human Services (HHS) announced that Phase 2 of its audit program has begun in order to assess compliance with the Privacy, Security, and Breach Notification rules under the Health Insurance Portability and Accountability Act of...
April 08, 2016
In a 6-3 decision announced Thursday morning, the U.S. Supreme Court ruled that the Affordable Care Act can continue to provide tax subsidies to eligible individuals who purchase insurance on either a federal or state exchange. In essence, this ruling maintains the status quo – that federal health care subsidies...
June 21, 2015
July 2013 – The Department of Treasury announced yesterday that it would delay by one year the Affordable Care Act requirement that large employers provide health insurance to their full-time employees. This means businesses will not be penalized in 2014 if they do not provide employees with health insurance. The...
July 20, 2013
Our attorneys have extensive experience providing legal services to a wide variety of health care clients across the country on challenging and sophisticated matters. By way of illustration only, our attorneys have:
- Organized physician practices, home health agencies, management service organizations, hospital physician practice subsidiaries and other health care providers and suppliers, which has included the preparation and negotiation of shareholder agreements, operating agreements, buy-sell agreements and related corporate documents.
- Structured physician and other referral relationships in accordance with the complex layers of federal and state regulation, including the federal Stark law, Anti-Kickback law and state corporate practice of medicine and licensure requirements.
- Conducted and closed significant private offerings for numerous health care businesses, including for example, skilled nursing and assisted living facilities, a cloud-based electronic medical record business, a cardiac output measuring business, a dental implant distributor, a physician owned hospital, an emergency room staffing business, ambulatory surgical centers, hospital co-management companies, research and development companies and pharmaceutical companies.
- Represented clients to organize and negotiate significant cutting-edge population health joint ventures, co-management companies and physician multispecialty joint ventures.
- Represented small and large physician practices in selling their respective private practices through stock, membership interest, asset or hybrid transactions to large nonprofit medical centers and to publically traded companies.
- Represented physician practices and other health care businesses merging with large physician groups or other businesses, forming new subsidiaries and acquiring other physician practices and businesses.
- Represented hospitals and health systems in the acquisition and divestiture of physician practices.
- Served as corporate and regulatory counsel for large national health care providers operating under the “friendly-physician” practice model.
- Assisted health care clients in obtaining venture capital and other private equity investments and senior and mezzanine bank financing.
- Advised client regarding roll-up with a biotechnology startup and related portfolio development companies.
- Negotiated a license agreement between a global biotechnology company and a therapeutics accelerator.
- Prepared and negotiated manufacturing and distribution agreement for medical supply kits with multiple medical facilities.
- Reviewed and negotiated numerous procurement contracts and real estate leases for hospital systems.
- Represented client in donation of MRI and related business to a large non-profit health care system.
- Provided health care regulatory and employment law compliance guidance to hospitals, health systems, physician practices, home health agencies, independent diagnostic testing facilities, laboratories, staffing companies, management companies and other health care providers and suppliers, including the preparation of policies and procedures and employee handbooks.
- Organized and served as corporate and regulatory counsel for Medicare accountable care organizations (ACOs) and a physician organization.
- Provided guidance to numerous health care clients regarding ambiguous and changing regulations under federal and private payor health care payment reform.
- Provided HIPAA, HITECH, Red Flags Rule and related data privacy and security guidance to clients through the preparation of policies and procedures, day-to-day compliance advice, business associate and data sharing agreements, employee training materials and other forms.
- Completed Medicare enrollment and change of information forms and assisted clients to resolve issues surrounding the same.
- Provided guidance to health care providers and medical device companies regarding the Physician Payments Sunshine Act and other federal transparency and reporting initiatives.
- Assisted physician practices and medical transportation businesses with Medicare billing audit defense.
- Assisted ambulatory surgery center and home health clients in responding to and preparing for governmental and accreditation inspections and surveys.
- Reviewed a professional employer organization agreement regarding outsourcing employees.
- Negotiated complete abatement of Ohio Department of Taxation Commercial Activity Tax assessment with the Ohio Attorney General regarding a surgery center.
- Developed stock appreciation rights plan for a group of emergency medicine physicians.
- Advised a global respiratory care designer, manufacturer, and marketer regarding employment and personnel issues.
- Reviewed and negotiated numerous employment agreements and executive severance agreements for health care clients.
- Provided ERISA and other employee benefit guidance to hospitals, health systems and other businesses.
- Provided employment law counsel and advice to a Greater Cleveland hospital system.
- Represented medical practices in a contractual dispute relating to the performance of and payment for billing services.
- Represented a clinical diagnostic testing and disease management company in restrictive covenant litigation.
- Represented a Northeast Ohio hospital in litigating Certificate of Need issues.
- Represented retail and compounding pharmacies in the acquisition and divestiture of pharmacy businesses and assets.
- Defended Medicaid fraud in a grand jury investigation against a dental practice, successfully obtaining a declination letter.
- Defended physicians, dental practices and pharmacies in state licensing board actions.
- Defended a private clinic in an investigation by the Ohio Department of Insurance.