Physician Group Practices & Management Companies

Overview

Our team is specifically dedicated to the unique legal needs of physician practices ranging from solo practices to large, multi-specialty groups. In many instances, the stakeholders are owners of the business and their legal needs encompass a wide-range of general business issues to specific regulatory requirements related to operation, ownership and payment to governance planning and individual professional planning and licensure issues. We also provide guidance in the development and operation of physician practice management companies throughout the nation.

We represent a wide variety of medical groups throughout the nation. The practice has in-depth experience addressing a wide-range of entity-level, internal issues such as physician compensation design, compliance plan development and training, governance issues, shareholder agreements, employment agreements, recruiting agreements, buy-in and buy-out arrangements and day-to-day labor and employment issues such as FMLA, wage and hour disputes, employee discipline and dismissal matters. The Physician Group team represents medical practices in State Certificate of Need issues related to the development of new institutional health services, Medicaid and Medicare audits, HIPAA audits and general compliance training. Our attorneys advise medical groups in the course of government investigations and audits of all types, including self-disclosures, repayments, and development of an ongoing compliance with Corporate Integrity Agreements.

The practice has significant experience with a variety of transactions such as sales to or joint ventures with hospitals or health systems; sales to private and publicly traded physician practice management companies; mergers with similar groups, and acquisitions. We have extensive experience in structuring such events in compliance with state and federal laws relating to physician-self referral issues, antikickback issues and antitrust issues. Our attorneys also have extensive expertise in counseling physician practice groups on the day-to-day contracts and contract disputes with third-party vendors, including software licensing issues. We counsel and negotiate medical office leases and tenant guarantees common within the industry. Our practice routinely advises medical groups with regard to mid-level clinical supervision requirements and related billing requirements. Our attorneys often counsel medical groups with regard to patient care issues, ADA requirements, and disruptive patient issues.

We also have extensive experience in addressing a range of issues affecting the individual physician, such as medical staff applications and disputes, discipline issues, state licensure issues, third-party consulting agreements, and intellectual property claims and disputes.

In addition to this broad substantive experience, our attorneys have diverse backgrounds and experiences in the healthcare industry, including those who have:

  • Served with the government, representing agencies such as the Centers for Medicare and Medicaid Services (CMS), the Department of Health and Human Services (DHHS), the Office of the Attorney General, and the Department of Justice (DOJ);
  • Served as Assistant United States Attorney, Assistant District Attorney and Deputy Attorney General;
  • Served as advisors on national advisory committees and task forces for CMS and trade associations;
  • Served as in-house experience in a variety of settings;
  • Served as officers of national and state health law and legal organizations;
  • Earned advanced educational degrees in healthcare;
  • Front-line work experience for institutional healthcare providers, nonprofit organizations and for-profit companies, including oversight responsibility for clinical trials; and
  • Held faculty positions at universities.

Experience

  • Represented a private equity client in its acquisition of three (3) physical therapy clinics.

  • Represented a private equity client in its acquisition of three (3) ophthalmology medical practices and their associated ambulatory surgical centers.

  • Assisted practice physician practice group with an investigation related to the reuse of single-use devices.

  • Represented a large medical practice in the redemption of departing shareholder physicians, including advice regarding post-shareholder employment and restrictive covenant enforcement issues.

  • Represented a national medical practice’s and management company’s expansion into multiple states, including advice regarding provider licensing and state corporate practice of medicine issues, including formation of new corporate entities as appropriate and drafting and negotiating provider employment agreements.

  • Represented a national medical practice and management company in the evaluation and response to federal and state HIPAA security and privacy matters.

  • Represented a large medical practice in the advice and negotiation of new physician employment agreements, including restrictive covenant issues.

  • Represented a national medical practice and management company with regard to physician employee issues, including advise related to termination of physician employees and applicable restrictive covenant issues.

  • Represented a national medical practice and management company in the analysis of accountable care organizations and advice regarding necessary corporate and regulatory structures to permit participation in multiple ACOs.

  • Represented multiple, large medical practices in the development of medical directorship agreements.

  • Represented a national medical practice and management company with regard to the negotiation of a new billing and collection agreement, including privacy and security matters and related indemnity obligations.

  • Represented a large hospital system in the development of a professional services agreement for the development and offering of general surgery services.

  • Represented a national medical practice and management company with regard to joint venture relationships with national health systems.

  • Represented a large hospital system in the development of a regional urgent care joint venture arrangement, including tax strategy, corporate structure and regulatory analysis.

  • Represented a large regional health system in the acquisition of a privately held, joint venture ancillary service provider.

  • Represented a large hospital system in the development of a single specialty (hospital-physician) joint venture ambulatory surgery center.

  • Represented a large single specialty physician group in the addition of new shareholders in both the main practice and ancillary lines of business.

  • Represented a single specialty surgery center in the negotiation, diligence, fraud and abuse counseling, and drafting of joint venture with a large regional health system.

  • Represented a national subspecialty services provider and management company in the analysis of related fraud and abuse issues.

  • Represented a national subspecialty services provider and management company in its corporate reorganization and national development.

  • Represented a national subspecialty services provider and management company in the acquisition of related providers.

  • Assisted a large regional hospital system in the development and negotiation of an exclusive provider agreement for hospital based services.

  • Represented a national subspecialty services provider and management company in the development, fraud and abuse counseling, and negotiation of national service line management program and related exclusive service provider agreements.

  • Represented one of the largest specialty medical practices in the Southeast in investigation by the U.S. Attorney’s Office alleging improper modifier 25 billing. Civil case settled for approximately one-third of the government’s demand.

  • Represented a large hospital system in the development of a system-wide, multi-specialty, physician practice acquisition strategy and process; including all documentation and negotiation.

  • Represented a large regional hospital system in the development of a professional services arrangement, including all aspects of the transaction, including due diligence, negotiation of primary agreements, regulatory filings (state and federal).

  • Represented developer in claims against contractor that misappropriated construction proceeds; secured favorable settlement in excess of sums taken.

  • Represented a group practice in the negotiation, diligence, fraud and abuse counseling, and drafting of a professional services agreement with a large regional health system.

  • Served as health regulatory counsel advising investor in a provider of management services to physician practices in thirteen states; worked with corporate counsel to draft and negotiate appropriate healthcare representations and warranties, escrow and indemnification provisions. Advised on risk under state laws applicable to the model, including corporate practice of medicine, fee-splitting and scope of practice,  as well as federal Anti-kickback issues as applied to management models in OIG advisory opinions and other guidance.

  • Represented a large hospital system in the negotiation and drafting of a specialty co-management agreement including all corporate transactional agreements and development of applicable co-management measurement metrics in compliance with federal fraud and abuse requirements.

  • Represented a physician specialty group practice in asset sale to tax-exempt hospital system and related development of a center of excellence. Varied employment arrangements for all acquired providers. Purchase price was in excess of $5 million.

  • Served as lead counsel for a development of regional 20+ physician group practice utilizing clinical integration and financial integration. Transaction included negotiation and establishment of employments agreements, operating agreement and management agreement in compliance with both federal fraud and abuse and anti-trust compliance requirements.

  • Represented a large hospital system in fraud and abuse analysis related to the development and securities offering of multi-specialty ambulatory surgery center.

  • Represented a large hospital system in the negotiation and drafting of a specialty joint venture agreement, including all regulatory analysis and drafting of corporate transaction documents.

  • Represented the largest healthcare practice of its type in Georgia in connection with a potential class action alleging race discrimination threatened by current and former employees. Although the Equal Employment Opportunity Commission indicated that it was going to pursue the case, we were able to negotiate a favorable settlement prior to suit being brought by the plaintiffs or the agency.

  • Successfully defended numerous physician practices with respect to related federal court actions alleging improper billing and secured an order granting sanctions against the plaintiff for filing a frivolous lawsuit.

  • Represented solo physician specialty practice in asset sale to publicly traded physician management company. Transaction included negotiation and transfer of exclusive services agreement with multiple area hospitals. Development of post-closing contingent compensation system tied to individual physician requirements and needs. Varied employment arrangements for all acquired providers. Purchase price was in excess of $4 million.

  • Represented a 30-physician specialty group practice in stock sale to publicly traded physician management company. Transaction included negotiation and transfer of exclusive services agreement with multiple area hospitals. Development of post-closing agreement on management and policy that included recognition of senior and junior physicians, intra-practice leadership and transition models. Varied employment arrangements for all acquired providers. Negotiation and early termination of office lease, including all physician guarantees. Purchase price was in excess of $70 million.

  • Represented a physician specialty group practice and related ambulatory surgery center in asset sale to tax-exempt hospital system and related development of a center of excellence. Transaction included development of post-closing agreement on management and policy.  Varied employment arrangements for all acquired providers. Purchase price was in excess of $4 million.

  • Obtained plaintiff’s verdict for physicians group, after three-week jury trial, in action for misappropriation of trade secrets and breach of contract resulting from the break-up of a medical practice.

  • Representing a medical practice and real estate development company in the analysis of Stark, federal anti-kickback, state certificate of need rules and corporate practice of medicine rules in conjunction with an analysis of various equity investment options to be made available to physician-investors in a $15 million medical office building and subsequent tenant-based health care service providers (e.g., laboratories, imaging centers).

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