Health Care

The health care industry has experienced impressive growth in recent decades. Those in the field have witnessed an equally dramatic increase in the compexity of the legal and market environments that they operate within. At Hinshaw, our Health Care Group helps clients thrive by offering practical, sound solutions to matters involving business activities, litigation, risk management measures and regulatory compliance.

Compliance and Regulatory Counseling
Hinshaw's Health Care attorneys are well-versed in regulatory compliance, addressing issues such as licensure, the Medicare and Medicaid Anti-Kickback Statute, the Ethics and Patient Referral Act (Stark), the Health Insurance Portability and Accountability Act (HIPAA), pharmacy, and maintenance of tax exemption under Section 501(c)(3) of the Internal Revenue Code. We have both drafted compliance programs for various types of health care providers and worked with health care clients to develop policies, procedures, standards of conduct, internal monitoring, auditing and corrective action plans. Our attorneys counsel on whether self-disclosure is necessary in certain cases and on developing remedial action plans. Hinshaw attorneys regularly sit on compliance committees for various Health care providers, as well as direct internal and external investigations, mindful of both discoverability issues and self-disclosure concerns.

Employee Benefits and ERISA Litigation
Hinshaw attorneys counsel and advise for-profit and tax-exempt health care clients in a wide range of complex employee benefits matters, including qualified pension and profit-sharing plans, health and welfare plans, and executive compensation and employment agreements. We represent clients in all types of litigation involving employee benefit plans under the Employee Retirement Income Security Act (ERISA) and other applicable laws. We likewise represent these businesses in connection with investigations by the Employee Benefits Security Administration of the U.S. Department of Labor and in connection with employee plan audit examinations by the Internal Revenue Service.

Our Employee Benefits and Corporate and Securities attorneys also work together seamlessly to help ensure the proper handling of employee plans and other benefit programs in mergers and acquisitions. Together, they advise buyers and sellers on due diligence issues, assist with the merging of target company benefit plans into acquiring company benefit plans, and aid in terminating or spinning off overlapping, conflicting or costly benefit programs.

Health Care Fraud, White Collar Crime and Internal Investigations
We have significant experience representing health care clients in all stages of grand jury investigations, civil investigative demands, criminal trials, related civil fraud litigation and administrative/regulatory enforcement actions. Our partners who practice in this area include former federal and state prosecutors.

Hinshaw's Health Care attorneys have conducted internal investigations for for-profit and not-for-profit health care providers. They assist clients in addressing not only the potential criminal sanctions they face, but also the related civil and administrative penalties, potential exclusion, civil fraud and related false claims qui tam litigation.

Hinshaw attorneys regularly advise health care clients on both the civil and criminal implications of noncompliance with the Medicare and Medicaid Anti-Kickback Statute and The Ethics in Patient Referral Act (Stark), as well as state self-referral laws. In virtually every health care transaction that we participate, we work with health care providers to ensure that the transaction is structured to be compliant with the Anti-Kickback Statute, Stark and relevant state self-referral requirements. Our attorneys have worked with hospitals and physician groups to develop physician recruitment programs that are compliant with the Anti-Kickback Statute, Stark legislation and tax exemption principles. In addition, we have worked to ensure that health care providers entering into agreements with physicians, including medical director agreements, comply with the applicable regulatory requirements both in the documentation and implementation of the transaction. In the development of joint ventures, whether surgery centers, imaging centers, sleep centers or specialty hospitals, we work with health care providers to avoid both Anti-Kickback and Stark prohibitions.

Health Information, Privacy and Technology
Hinshaw attorneys are familiar with the unique requirements clients face regarding the sensitivity of health information. Common law, state law and federal law through HIPAA all enforce the general requirement that a patient's relationship with Health care providers is a private one. Hinshaw's Health Care attorneys assist clients in preparation of compliance policies, rules, regulations and procedures. They also advise clients regularly on whether a particular disclosure is allowable under both relevant state and federal law.

Hinshaw attorneys frequently represent clients in court to protect sensitive health information involving mental health, substance abuse and HIV treatment records. Attorneys within the firm also focus their practice in hardware/software security issues and counsel clients concerning their relation to electronic medical records and the HIPAA security provisions.

Health Planning
Hinshaw attorneys represent clients in Illinois in the process of obtaining required Certificate of Need (CON) permits or exemptions from the Illinois Health Facilities Planning Board. This representation includes analyzing when a permit or exemption is required and, if so, assisting in drafting an application that complies with the Board's rules and, thus, maximizing the opportunity for approval in a reasonable time frame. Our Health Care attorneys also assist clients in holding and preparing for public hearings that are part of the CON process. When necessary, we represent clients through the administrative review process. Hinshaw Health Care attorneys are familiar with health planning regulations in states other than Illinois as well. In addition, we assist clients in the general health planning process to maximize access to care while minimizing duplication of services and enhancing cost efficiency.

Licensing and Credentialing
Hinshaw's Health Care attorneys offer a myriad of services with regard to licensing, accreditation and credentialing. We have assisted providers of all types in obtaining required licenses, and in assuring compliance with licensure standards, Medicare Conditions of Participation, accreditation standards and other regulatory requirements pertinent to license issues.

Facilities that are subject to CMS/DPH surveys frequently must respond to Department of Public Health findings with Plans of Correction and other relevant material. We help our health care clients in negotiating with regulators and preparing a corrective action plan that addresses cited deficiencies. We also analyze how various contemplated business arrangements are impacted by license issues and vice versa, and how reimbursement can be maximized with appropriate licensing, accreditation and credentialing standards in mind. Additionally, we represent a variety of individuals and institutional providers in maintaining certification within the Medicare and Medicaid programs. Finally, we assist licensed individuals in defending against allegations that their behavior has violated any applicable licensure standards.

Medical Research
Hinshaw attorneys counsel Independent Review Boards with respect to their policies and procedures. We address issues involving clinical trials, including those involving recruitment of subjects and investigators; obtainment of properly documented informed consent from human research subjects; and adverse event reporting, ethics and conflict of interest analysis. We also assist clients with Office for Human Research Protections issues; HIPAA and state privacy compliance and Clinical Laboratory Improvement Act issues; and other federal and state laws and regulations relating to medical research.

General Counsel
We act as general counsel for several health care businesses. In doing so, we regularly communicate with them to address the myriad of legal issues that arise for any business, in particular those affecting the highly regulated health care industry. We frequently participate on client committees and attend board of director’s meetings, client retreats and similar activities. As general counsel, we are proactive in assisting health care clients avoid the need for legal services in more complex circumstances, such as when compliance, litigation or regulatory challenges arise.

Medical Staff
Our Health Care attorneys recognize the unique relationship between the institutions we serve and their medical staffs. We have written and revised medical staff bylaws and counseled both hospitals and physicians with respect to medical staff disputes, the credentialing process, peer reviews and quality improvements. We regularly attend Medical Staff Bylaw Committee meetings and work with medical staffs to assist them in understanding the role of the hospital in developing and maintaining medical staff bylaws. We also become involved in fair hearings, and represent institutions and physicians in fair hearings pursuant to medical staff bylaws and in related litigation when necessary.

Hinshaw has represented hospitals in cases setting the leading precedents with respect to medical staff related disputes. Our Health Care attorneys counsel clients regularly pertaining to all types of Medical Staff issues. We work with clients to resolve these issues while recognizing the complex relationships which exist.

Health Care Litigation
Hinshaw attorneys have significant experience in representing Health care clients in sophisticated white collar criminal and related Health Care fraud cases. Our more than 300 trial lawyers nationwide work closely with the firm's Health Care attorneys to successfully resolve health care clients' litigated matters. This includes representing clients in the areas of business disputes, contracts, real estate, tax, regulatory, medical malpractice defense, employment and administrative litigation.

Transactions and Joint Ventures
Our Health Care and Business attorneys work collaboratively to assist clients with health care related transactions, including structuring and negotiating mergers and acquisitions involving hospitals and hospital systems, and structuring and negotiating sales and purchases of companies, from dialysis providers and nursing homes to durable medical equipment companies. These lawyers are experienced in handling commercial litigation, employee benefits, finance, real estate, regulatory practice and tax matters. They assist in arranging appropriate financing or strategic partnerships, and in private placement and public offerings.

This multidisciplinary team is also involved in acquisitions and divestitures of managed care organizations, structuring joint ventures between institutions and practice groups, and corporate restructuring. They assist clients with health care due diligence and troubleshoot compliance issues that occasionally arise during the course of a health care transaction so that the issues do not become problematic with respect to the overall transaction itself. Our regulatory practitioners assist with the transfer of licenses which often occurs in health care transactions, and other regulatory issues, including transferring Medicare and Medicaid provider numbers, when necessary, and in handling other related reimbursement issues.

Real Estate
Hinshaw's Health Care and Real Estate attorneys frequently collaborate to assist our health care clients in real estate transactions. This includes in the negotiation for lease, sale and/or purchase of either improved or unimproved real estate; mortgage and loan structuring; environmental and zoning matters; and resolution of general real estate disputes. We have assisted health care clients in developing medical office buildings and the health planning process that occasionally goes hand in hand with real estate transactions. We are also experienced in negotiating construction, architectural, engineering and site development contracts and in any related litigation. We are likewise well versed in assisting our not-for-profit health care clients with respect to real estate tax exemption issues and in public relations with the communities that these businesses serve as it relates to real estate acquisition and divestiture and tax exempt status.