Growth. Performance. Managing risk. However you define it, success in today’s health care age means addressing increasingly complex issues faster and more efficiently amid rapid change. Making the right decisions in this environment requires strategic counsel from an advisor who not only knows how laws are evolving in jurisdictions around the United States, but also has a deep understanding of your particular industry.

Our attorneys practice in the following core areas and can provide unparalleled, experienced advice and assistance to health systems, hospitals, and medical staff leaders needing assistance with such matters.

DRAFTING AND CONSULTING ON MEDICAL STAFF DOCUMENTS, INCLUDING, BUT NOT LIMITED TO:

      • Medical Staff Bylaws Documents
      • System Medical Staff Bylaws Documents
      • Medical Staff application forms
      • Medical Staff Rules and Regulations
      • Peer Review/Professional Practice Evaluation Policies and Related Forms
      • Medical Staff Professionalism Policies
      • Practitioner Health Policies
      • Policies on the Use, Disclosure, and Retention of Confidential Credentials/Peer Review Files
      • Information Sharing Agreements (for Health Systems)
      • Policies/Documents Governing CVOs/Delegated Credentialing
      • Policies on Review of Concerns Related to Utilization
      • Low or No Volume Practitioners Policies
      • Policies on Practitioner Re-Entry to Practice
      • Policies on Responding to Reference Requests about Practitioners
      • Other Policies that Relate to Medical Staff Matters (e.g., scheduling protocols, medical record documentation, patient safety training initiatives)

CONSULTATION ON MEDICAL STAFF MATTERS, INCLUDING:

      • Management of credentialing and peer review matters
      • Delineation of clinical privileges, as well as matters involving scopes of practice and related supervision requirements and conditions on practice for advanced practice professionals and dependent practitioners
      • Audits of credentialing and peer review processes
      • Communications regarding credentialing matters, including: letters informing applicants of ineligibility for appointment/privileges, that an application is incomplete (and specifying additional information required prior to processing), or that an application has been denied.
      • Communications regarding peer review matters, including letters that memorialize collegial intervention efforts, outline the basis for a precautionary suspension, inform the practitioner that an investigation has been commenced, or seek the practitioner’s input about a clinical or conduct issue that is being reviewed as part of the peer review process.
      • Development of formal Performance Improvement Plans
      • Medical Staff investigations
      • Fair hearings and appeals (representing the Board or MEC, as applicable)
      • National Practitioner Data Bank (NPDB) reporting
      • Hearing Officer/Presiding Officer service (in cases where we have not served as an advocate)
      • Accreditation issues regarding governance and Medical Staff matters

DAY-TO-DAY CONSULTATION ON CORPORATE MATTERS, INCLUDING:

      • Drafting Corporate/Governance Bylaws
      • EMTALA and On-Call policies (and consulting on management of alleged EMTALA violations)
      • Exclusive contracting and closing of clinical departments
      • Service lines and centers of excellence
      • Medical Staff Development Planning
      • Fraud and abuse and other compliance implications of transactions
      • Medical necessity inquiries and audits
      • Self-disclosures to CMS and the OIG

DRAFTING, NEGOTIATING, AND CONSULTING ON PHYSICIAN EMPLOYMENT MATTERS, INCLUDING:

      • Physician employment contracts
      • Hospital-based physician contracts
      • Physician recruitment agreements
      • Physician practice acquisition contracts
      • Practitioner vetting, peer review, information sharing, and related matters in the ambulatory setting
      • CEO, CMO, and other C-suite employment contracts
      • Leases and other health care transactions

LITIGATING (OFTEN IN CONJUNCTION WITH LOCAL LITIGATION COUNSEL) LIMITED MATTERS, INCLUDING:

      • Defense of lawsuits based wholly or partly on a credentialing or peer review dispute
      • Physician contract disputes
      • Health care antitrust matters
      • Hospital tax exemption defense
      • Fraud and abuse/Anti-kickback/Stark/False Claims Act defense and settlements for hospitals

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