Breadth of experience. Up-to-date industry knowledge. Innovation. Commitment to client service.
These are concepts that health care providers depend upon from their legal counsel. And these concepts are at the core of Womble Carlyle’s Health Care Practice. We have represented health care providers for almost a century. As a result, we have experienced firsthand the evolution that has transformed health care into one of the largest and most complex and highly regulated industries in the United States. We have served on the front lines with clients, dealing with the constantly changing regulatory and business issues that are distinct to health care.
Our multidisciplinary team approach allows Womble Carlyle attorneys to provide clients with practical, comprehensive expertise to help the client achieve its clinical and business goals and better serve its patients. Hospitals and other health care providers encounter a wide range of legal issues, and we have helped such clients navigate matters such as organizational issues, capital formation, regulatory compliance, patient safety, tax-exempt status, peer review and patient safety, risk management, joint ventures, intellectual property issues, commercial real estate, employee benefit plans and all types of formal and informal dispute resolution.
More than 50 attorneys combine with the Firm’s long history of serving health care clients to make Womble Carlyle’s Health Care practice one of the most experienced health care practices in the Southeast and Mid-Atlantic regions.
Womble Carlyle is particularly focused on assisting hospitals, physician groups, long-term health care providers and primary health care groups in complying with often-complex regulatory requirements while achieving their business and clinical objectives. Our experience includes (click on a topic to learn more):
Regulatory & Compliance
Our attorneys counsel health care providers with respect to regulatory and compliance issues that they may face from time to time.
Womble Carlyle's Health Care team is experienced in representing health care on anti-kickback issues; physician self-referral provisions ("Stark" and related regulations); antitrust compliance; civil monetary penalty issues; and licensure, credentialing, certification and certificate of need matters.
Our health care lawyers advise clients on traditional operational issues, such as complying with the Emergency Medical Treatment and Active Labor Act (EMTALA) and the standards of the Joint Commission, assessing when to run background checks (criminal and credit), analyzing informed consent, and assessing advance directive implementation issues. We also can provide you with continued representation during investigations (internal and external) and legal audits.
Antitrust
Womble Carlyle is the top-rated law firm in North Carolina for Antitrust Law, according to Chambers USA, and health care antitrust issues are a particular area of focus. We represent hospitals and other health care providers in FTC and state audits as well as antitrust litigation with such issues as contracting disputes, monopolization claims, price-fixing allegations, mergers, joint ventures and conspiring to restrict trade claims. Our team includes a former Assistant Director of the Bureau of Competition of the Federal Trade Commission in charge of health care enforcement.
Corporate & Transactions
Should you need counsel in antitrust and merger & acquisition matters, Womble Carlyle has represented health care providers in all manner of these transactions. We routinely counsel clients on antitrust laws, unfair and deceptive trade practices and unfair competition laws. Our team has established a national practice in securing federal and state antitrust clearance for mergers and acquisitions of hospital systems and health plans.
Our business transaction experience also includes representation in matters such as hospital syndication with physicians, joint ownership of MSOs, physician practice acquisitions, joint ventures for laboratories and other services.
We also help health care providers, including large hospital systems, with corporate governance and organizational documentation.
Hospital-Physician Issues
Womble Carlyle has extensive experience working with hospitals on issues related to physicians and other health care providers, including:
- Physician employment agreements;
- Physician recruitment;
- Medical Director agreements;
- Independent contractor relationships;
- Hospital acquisition of physician practices;
- Hospital residency programs;
- Drafting and modifying medical staff bylaws;
- Conducting peer reviews and medical staff hearings;
- Payment for call coverage; and
- Patient Safety Organizations
Health Care Litigation
Business litigation has been an area of focus for Womble Carlyle for more than 130 years. We have experience representing hospitals and health care providers in just about every form of litigation imaginable, including contract disputes with third-party partners, medical staff credentialing disputes, qui tam whistleblower complaints, medical practice break-ups, white collar crime and government investigations, antitrust challenges and patent enforcement/infringement actions.
Data Privacy
Protecting confidential information is critical for health care providers, who must comply with specific federal and state laws to protect patient information. We can assist you with a full range of privacy and security compliance services, such as:
- Customized HIPAA compliance audits for all types of health care providers, laboratories and life science companies;
- Employee compliance training;
- Policy, procedure and document review and consultation;
- Negotiate and review contracts with outside vendors to ensure HIPAA compliance;
- Representation in HIPAA disputes; and
- Compliance with the Health Information Technology for Economic and Clinical Health Act (HITECH), which imposes stricter regulatory requirements for health care providers under the privacy and security portions of HIPAA.
We also work with health care clients to ensure compliance with all applicable state laws governing patient and employee data privacy.
Our attorneys also help clients with the complex and ever-changing field of Health Information Technology, which has a strong connection to privacy and data security issues. Our work in this field includes:
- Purchasing and implementing HIT systems, including EHR, practice management and PHR;
- Addressing the regulatory issues associated with HIT, including privacy and security compliance;
- Implementing agreements for connectivity and data transfer between health care clearinghouses, payers, providers and pharmacies;
- Building strategic alliances for the resale, sublicense, and use of health-related technology;
- Negotiating data release agreements for the sharing of health information;
- Assisting donors and recipients of interoperable EHR with anti-kickback, Stark, and tax compliance;
- Working with government agencies and regulators to better understand the rapidly evolving framework of HIT regulation; and
- Resolving HIT disputes between providers and/or HIT vendors.
Tax-Exempt Status
Our attorneys routinely work with health care providers to establish and safeguard their tax-exempt status. For example, we have counseled hospitals in considering the potential effects of joint ventures and other arrangements with for-profit entities on their tax-exempt status.
Recently, the IRS authorized major changes in Form 990, the primary annual financial reporting document for non-profit organizations. The revised Form 990 places a greater reporting burden on non-profits, particularly in the areas of executive compensation and corporate governance. Womble Carlyle is working with health care providers to ensure compliance with these increased reporting guidelines.
Third-Party Reimbursement
We advise health care providers with issues related to third-party reimbursement, including Medicare and Medicaid reimbursement and enrollment. Our team works with providers to structure reimbursement transactions to minimize potential fraud and abuse claims, and we represent clients before the Provider Reimbursement Review Board.
Government Audits & Investigations
Our goal is to prevent government audits and investigations before they happen. We help health care providers craft policies and implement procedures to prevent government action, and we also maintain good relationships with federal and state agencies to work through potential conflicts.
But we also vigorously defend our health care clients in such federal and state actions as False Claims Act, Whistleblower (Qui Tam), and alleged Medicare and Medicaid fraud and abuse claims. We have represented clients in investigations involving the Department of Health and Human Services Office of Inspector General, the Centers for Medicare and Medicaid Services, the Federal Trade Commission and the U.S. Department of Justice, as well as related state agencies.
Capital Finance
In today's economic climate, raising capital funds can be extremely challenging, even for vital institutions such as hospitals. But we can help.
Our public finance attorneys have been involved in nearly every type of tax-exempt financing, including general obligation bonds, revenue bonds, certificates of participation and installment financing agreements, industrial revenue bonds and conduit bonds issued for nonprofit organizations.
Our public finance experience includes assisting the University of North Carolina Health Care System, Novant Health, Inc. and North Carolina Baptist Hospitals with capital finance projects. We also have helped life care facilities with capital finance issues.
Employee Benefits & Compensation
We work with all sizes of health care providers to craft and manage employee benefit and compensation plans. We work to ensure that such plans not only stand up to rigorous federal and state regulation, but also serve the practical business needs of the employer.
We assist health care providers with all of the legal issues surrounding health care, disability and life insurance plans, as well as both qualified and non-qualified retirement plans. We also help health care providers with the unique and complex issue of self-referral issues in compensation plans.
Finally, executive compensation is coming under increased scrutiny from shareholders, lawmakers and the general public. We work with hospital Boards of Directors to craft sensible executive compensation plans mindful of the current political climate.
Labor & Employment
Our team works with hospitals, health care providers and other medical employers on a full range of employment law issues, including:
- OSHA compliance and dispute resolution;
- Wage/hour claims;
- ERISA (Employee Retirement Income Security Act) defense against claims brought by plan participants or the Department of Labor;
- ADA (Americans With Disabilities Act) compliance; and
- EEOC claims and subsequent litigation.
In addition, we counsel employers on employment issues so they can proactively avoid litigation and minimize liability exposure. In this capacity, we regularly advise employers on layoffs and related WARN Act considerations, union organizing campaigns and collective bargaining negotiations, wage and hour inspections, and OSHA compliance reviews. We also help employers with employee handbooks, drug testing programs, affirmative action plans, and employment policies.
Third-Party Issues
Health care providers must deal with a myriad of issues related to vendors and other outside business partners. We work to represent the interests of health care clients in payer participation agreements, clinical research partnerships, vendor contracts and sponsorships. We work to ensure that our clients best interests are represented in negotiations and that intellectual property rights are held securely by third-party partners.
