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Proskauer Rose LLP has one of the leading health care industry practices in the world. We combine our extensive health law and industry experience with the resources and depth of an international law firm of over 750 attorneys in eleven offices across the U.S., Europe and South America. This unique blend of capabilities has enabled us to become an effective, trusted advisor to both well-established and emerging health care companies. For more information about this practice area, contact:
Participants across the health care industry
rely on us for the highest quality corporate and
transactional, regulatory, reimbursement, litigation,
labor, and tax representation. We advise both
investor-owned companies and not-for-profit organizations
and understand the dynamics of this industry,
from services and managed care to health information
technology and life sciences.
We bring together legal skills, industry knowledge,
business savvy, and policy insight to provide
you with creative solutions and representation
that is second to none.
- Health Service Providers
- Academic Health Centers
- Hospitals & Health Systems
- Ambulatory & Ancillary Service Providers
- Medical Groups
- Health Plans & Care Management Firms
- Health Care Suppliers & Distributors
- Information & Medical Technology Companies
- Pharmaceutical, Medical Device & Other
Life Science Companies
- Health Care Investors & Financial Institutions
Your organization faces an array of complex regulatory
and business challenges that demand legal support
across a range of disciplines. We respond to these
challenges with a comprehensive range of services,
including:
Corporate and Transactional Practice
We help clients document, conduct due diligence,
achieve regulatory compliance, and execute such
health care corporate transactions as:
- Mergers & Acquisitions
- Joint Ventures & Strategic Alliances
- Complex Commercial Agreements
- Affiliations, Research Collaborations, &
Licensing Agreements
- Equity & Debt Financings
- Restructurings and Workouts
These transactions require both corporate capabilities
and in-depth knowledge of applicable health care
laws. We add value for our clients through focused
due diligence, attention to health care representations
and warranties, and careful consideration of the
reimbursement implications of a chosen transaction
structure.
Our corporate practice also includes working
with Boards of Directors to assure compliance
with best practices in corporate governance.
Regulatory Compliance
We are recognized for our regulatory compliance
expertise. We counsel clients on the myriad laws,
including state and federal Stark and Anti-Kickback
laws, regulating the health care payment and delivery
systems. Proskauer also defends federal and state
False Claims Act matters based on violations of
such laws or other alleged improprieties. Indeed,
Proskauer has served as defense counsel in some
of the largest qui tam cases in history. We also
routinely assist clients in creating and maintaining
effective compliance systems, and have substantial
experience in dealing with complex self-disclosure
issues.
Clients also rely on our help to meet other important
health care regulatory requirements including:
- HIPAA Privacy, Security and EDI Rules
- Antitrust compliance
- EMTALA
- FDA (510K and pre-market clearance; marketing
and promotion rules; oversight of human cellular
and tissue-based products, blood banking, and
wholesale distribution)
- Institutional Review Board requirements
- Medicaid Rebate and 340b Laws
- ERISA Requirements applicable to welfare plans
Provider clients look to Proskauer Rose to handle
all aspects of state licensure and certificate
of need requirements, including establishment
of new providers, change of ownership (CHOW),
and facility construction and financing. We also
represent managed care clients before state agencies
in matters relating to licensure of new plans,
transfers of licenses, approval of provider contracting
forms, and state investigations and audits.
Third-Party Reimbursement
We help clients determine the availability and
amount of reimbursement from third-party payers,
including Medicare, Medicaid, and commercial payers.
They look to us for assistance with everything
from obtaining coverage for a new product or service,
to challenging the adequacy of reimbursement they
have received. Recently, we have been engaged
in evaluating Gainsharing and Pay-for-Performance
arrangements.
Our attorneys can help you manage all aspects
of your third-party reimbursement, payment and
pricing programs, including:
- Medicare Part A (facility)
- Medicare Part B (professional, outpatient,
and Part B-covered drugs)
- Medicare Advantage Plans
- Medicare Part D (drug benefit)
- Medicare Health Support, PACE, and other Demonstration
Programs
- Self-Insured and Insured ERISA Welfare Funds
- Medicaid Traditional Reimbursement and Medicaid
Managed Care
In connection with our Medicare and Medicaid
reimbursement work, we work closely with the U.S.
Centers for Medicare and Medicaid Services (CMS).
We also represent state Medicaid agencies as they
grapple with issues such as plan design, federal
financial participation, and federal waivers.
Our clients regularly come to us for guidance
concerning new reimbursement rules, regulations
and agency and court decisions that may affect
their success, and for assistance in negotiating
managed care, TPA, and PBM contracting.
Proskauer is a leader in reimbursement litigation
and has handled many class actions and individual
provider lawsuits, representing clients in significant
cases in state and federal venues across the nation.
Litigation
Proskauer Rose LLP advances and defends the interests
of a broad range of health care industry participants,
including hospitals, long-term care facilities,
pharmacy companies, service providers, trade associations,
health maintenance organizations, and suppliers.
We have successfully litigated many significant
cases, including class action litigation, covering
virtually every aspect of health care law.
Proskauer's lawyers represent health care providers
in confidential internal investigations and the
defense of allegations of fraud involving government
programs. We also represent providers in criminal
investigations of patient abuse and in related
civil actions. As noted above, our litigators
are recognized for their expertise in the defense
of qui tam lawsuits brought under the False Claims
Act, and they have represented numerous providers
and suppliers in many of these "bet the company"
cases.
Our Medicaid reimbursement litigators have handled
significant cases in state courts across the country.
Numerous nursing homes and hospitals have relied
on our litigation skills before the Provider Reimbursement
Review Board, state and federal trial and appellate
courts across the country, and in the U.S. Supreme
Court.
In recent years, clients have increasingly looked
to us for assistance with quality-of-care issues
and related litigation. This expertise is rooted
in our extensive involvement with reimbursement
issues and the government's use of provider licensing
and certification as regulatory tools. Quality-of-care
litigation has since become a major component
of our litigation practice.
Proskauer's administrative litigation practice
has distinguished itself in helping health care
providers in de-licensure and decertification
actions. Clients have counted on our defense strategies
in countless proceedings before the CMS, as well
as before licensing and certification agencies
in most of the fifty states.
We also have considerable expertise in litigating
managed-care payer disputes, presenting cases
in both state and federal courts, as well as in
arbitration proceedings.
Employment, Benefits and Labor
Proskauer's Labor and Employment Law Group works
with health care clients on a full range of employment-related
issues, including:
- Employee organizing
- Collective bargaining agreements
- Labor arbitrations
- Equal opportunity law
- Employment discrimination
- Appointment or termination of medical staff,
house staff and medical students
- ERISA
- OSHA compliance
Tax and Executive Compensation
Our Tax Department helps health care clients
structure corporate transactions and deal with
the unique issues of the health care industry.
We are particularly experienced in structuring
transactions between for-profit and tax-exempt
entities, and advising with respect to:
- Tax-exempt and public charity status
- Unrelated business income tax
- Private benefit and inurement rules
- Executive compensation
- Private foundation rules
- Fundraising
- Intermediate sanction matters
Our tax controversy lawyers represent clients
during the tax audit process, in court and at
administrative appeals before the IRS and state
and local taxing authorities. Clients also count
on us to pursue private rulings on a variety of
issues from the IRS and from state and local authorities.
In the employee benefits and executive compensation
areas, individuals and companies come to us for
assistance with tax, ERISA and other aspects of
qualified and non-qualified plans, welfare and
fringe benefit plans, golden parachute and deferred
compensation arrangements, stock options and other
equity-based arrangements, as well as with all
aspects of executive employment agreements.
Our executive compensation practice handles all
aspects of compensation and benefits law for senior
executives and other managers. Our tax lawyers
structure all types of equity arrangements, such
as stock option, restricted stock and phantom
stock arrangements, as well as use of stock in
qualified plans and other incentives. In addition
to drafting and assuring legal compliance of plans,
we help you design the arrangements and alert
you to potential accounting issues. Proskauer
also handles all types of non-equity executive
compensation arrangements, including supplemental
executive retirements plans, deferred compensation
arrangements, rabbi trusts, and incentive plans.
We believe we can offer you and your business
a unique combination of interdisciplinary legal
skills, knowledge of the health care business
environment, and insight into emerging industry
trends and government policy.
We will view our work with you as an opportunity
to become your trusted advisor, working as your
partner on the most important, complex and sensitive
challenges facing your organization.
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