Healthcare Provider Management

Capabilities / Healthcare Providers

Healthcare Providers

On the front lines of the healthcare industry.

С��Ѽ��Ƶ understands the complex market demands that healthcare providers face, and we’re committed to helping them keep ahead of the constantly shifting healthcare landscape. We draw on our experience and comprehensive industry knowledge in advising providers on transactions, regulatory compliance, labor and employment challenges, privacy and data security concerns, and litigation.

Our guidance to clients in the healthcare providers sector includes:

Academic medical centers

С��Ѽ��Ƶ takes a holistic approach to its partnerships with more than 400 hospitals, research entities, and institutions of higher education. Drawing on the resources of our full-service firm, our attorneys provide transactional, compliance, and operational counsel; training; government affairs advocacy; and litigation and enforcement defense.

Ancillary services

Clients that provide care outside of traditional hospital and doctor’s office settings trust our counsel on licensure and certification, physician practice management, and risk management. Our team also advises on public and private financing vehicles and regulatory compliance, including state fraud and abuse statutes and regulations of the Centers for Medicare and Medicaid Services (CMS).

Behavioral health

С��Ѽ��Ƶ has significant experience handling legal issues unique to behavioral health providers, such as privacy, restraint, and seclusion, and chemical dependency. Our team also advises on compliance, reimbursement, labor and employment, litigation, and the application of general healthcare laws – such as the Emergency Treatment and Active Labor Act (EMTALA) – in a behavioral health context. Further details about our Behavioral Health work are available .

Children's hospitals and pediatric providers

С��Ѽ��Ƶ understands the unique challenges associated with the ever-changing delivery of healthcare services to a vulnerable population of children and their families. Our counsel includes physician recruitment and integration strategies, regulatory compliance, innovative uses of accountable care networks, outcome-oriented reimbursement methodologies, captive insurance plans, and telehealth networks.

Hospitals and health systems

Our team is on the cutting edge of hospital industry advancements, developing innovative relationships between hospitals and providers and even between multiple hospitals and hospital systems. We advise hospitals and health systems on compliance and regulatory matters, including fraud and abuse avoidance and all aspects of Medicare, Medicaid, Stark Law, and federal anti-kickback law. Labor and employment, research and technology, and strategic transactions are other areas of focus for our team.

Pharmacy, specialty pharmacy, and pharmacy benefit managers

С��Ѽ��Ƶ is one of the only law firms in the country with an entire group devoted to pharmacy law and practice. Our attorneys offer pragmatic and strategic counsel on complex matters such as Medicare and Medicaid coverage and provider enrollment, billing and reimbursement, federal and state fraud and abuse laws, patient privacy and data security, and licensing and accreditation requirements. We also advise on transactions, investigations, and litigation.

Physicians and other professionals

The С��Ѽ��Ƶ team has decades of experience advising physicians and other professionals on the nonclinical aspects of their business, often serving as primary outside counsel. We help providers resolve reimbursement issues, analyze potential business transactions, and develop strategies for growth, including through innovative integration arrangements, network development, and ancillary ventures.

Post-acute care providers

Our team has the depth and breadth of knowledge to help our clients’ businesses grow along with the aging U.S. population. Our counsel to skilled nursing facilities, senior living facilities, and other post-acute care providers includes licensure matters, corporate compliance, internal investigations, privacy, data security, and Medicaid certification.

Rural health providers

Our team understands the unique situations our clients face in delivering high-quality healthcare to rural communities. We provide counsel on the development of provider networks and affiliations with large health systems, access to capital and equipment, licensing and certification, IT support and compliance, and provider staffing models and telehealth support. We also assist with regulatory compliance and reimbursement issues unique to rural providers.

Client Success

Physician Group Receives Substantial Reduction in Overpayment

Representative Experience

Represented hospital systems and medical groups in developing, negotiating and implementing service line management agreements.
Assisted hospital systems and physician groups with the sale and acquisition of medical practices and other affiliations.
Assisted multispecialty physician groups in developing and applying for approval from Centers for Medicare and Medicaid Services (CMS) as shared savings ACOs.
Assisted ACOs in negotiations with health plans for commercial products and analyzed antitrust issues regarding the joint negotiation with health plans based on clinical integration.
Represented provider networks and quasi-networks such as IPAs, PHOs and ACOs in provider contracting, quality assurance, utilization review, and claims payment. We also counseled on risk-based contract negotiations, gain sharing, insurance, and licensure.
Assisted a children’s hospital in preparing a comprehensive analysis of alternative contractual relationships with an ACO-like organization affiliated with another pediatric hospital. We handled the contract negotiations and analyzed federal antitrust, tax, and healthcare regulatory matters for the new network.
Created a multi-community, clinically integrated PHO involving two hospital systems.
Participated in American Health Lawyers Association’s work groups for Managed Care and ACO and Bundled Payment.
Advised providers on antitrust implications of joint venture transactions, development of ACOs, integrated networks, managed care contracting, and price and cost surveys among competitors.
Structured and developed pediatric provider networks designed for Medicaid managed care and/or commercial payor contracting.
Represented Medicaid providers in supplemental reimbursement Disproportionate Share Hospital (DSH) appeals and consult on Upper Payment Limit (UPL) program development.
Designed and developed patient safety organizations unique to children’s hospitals.
Designed, developed and evaluated compliance with federal research regulations (informed consent/IRB issues), NIH Grants Policy Statements, and federal investigations involving pediatric research.
Provided counsel regarding GME matters, including community provider/educational institution affiliation models, funding and resident allocation considerations, resident and medical student supervision requirements, and appropriate billing practices as they relate to teaching physicians and academic institutions.
Advised on day-to-day operational issues impacting pediatric providers such as consent, guardianship, and child abuse/ neglect reporting requirements.
Defended psychiatric hospitals and psychiatric residential treatment facilities in decertification proceedings, including immediate jeopardy situations.
Developed a multi-state guardianship and consent matrix and decision tool for client currently being utilized by providers in Colorado, Kansas, Montana, Utah, and Wyoming to help front line personnel navigate sensitive and oftentimes highly controversial situations related to the terminally ill and end of life decisions, durable power of attorney and healthcare proxies, minor consent issues, and guardianship.
Led a lengthy and complex negotiation between anesthesiology group and hospital to facilitate the transition of 11 anesthesiologists and select clinical and operations staff to the hospital.
Successfully negotiated major updates to joint venture arrangement between a neuro service provider and a large health system in Arizona which led to the provider working with the hospital to build and develop a new offering, a neuro services tower.
Assisted hospital in preserving relationships with departing cardiologists who were forming an independent group. Created complex, comprehensive set of arrangements with cardiologists and outside management company to preserve services to hospital patients.
Merged three orthopedic practices with very different compensation structures, varied affiliations, and different management approaches into one single large orthopedic practice, the largest in western Missouri and eastern Kansas.
Represented healthcare provider in defending against a GAO bid protest challenging the Federal Bureau of Prisons’ award of a contract to the client for substance use and mental health treatment services.
Represented infusion care provider and specialty pharmacy in dispute with insurance company over wrongful denial and underpayment of insurance claims.
Represented physician-owned hospitalist practice in a suit for breach of contract, tortious interference with existing contracts, and conspiracy to tortiously interfere with existing contracts.

Blog | June 11, 2025

Articles | Spring 2025

Blog | May 22, 2025

Blog | May 07, 2025

Legal Updates | April 10, 2025

Massachusetts Codifies ‘Shield Law' Protections for Physicians

Podcast | April 02, 2025

James McClendon Appears on WTW's Vital Signs Podcast to Discuss Navigating Medical Board Complaints

Articles | February 10, 2025

Articles | February 05, 2025

Articles | February 02, 2025

Articles | January 24, 2025

ICE at Healthcare Facilities: What Should You Do

Blog | January 15, 2025

Blog | January 09, 2025

Legal Updates | January 08, 2025

Massachusetts BORIM Sets Parameters for New Licensing Pathway

Blog | November 13, 2024

Articles | October 14, 2024

Articles | September 13, 2024

Blog | September 04, 2024

Articles | August 26, 2024

Articles | August 24, 2024

Articles | July/August 2024

Blog | August 19, 2024

Podcast | July 21, 2024

Value-Based Care Insights: The FTC Ruling's Impact on Physician Contract Negotiations

Podcast | July 18, 2024

Voices in Health Law Podcast: What is Medicaid Managed Care?

Blog | July 18, 2024

Articles | July 12, 2024

Articles | July 09, 2024

Jonathan Porter Authors Law360 Article on 6 Lessons from DOJ's First Controlled Drug Case in Telehealth

Articles | May/June 2024

Missouri Medicine: Physician Organizing: Trends and Takeaways

Blog | June 14, 2024

Articles | May 31, 2024

AHLA Health Law Weekly: Surviving a Bad Survey - Tips for Advising Health Care Providers

Articles | May 08, 2024

Legal Updates | May 06, 2024

Massachusetts Public Health Council Approves Hospital Occupancy Reporting Requirements

Legal Updates | April 22, 2024

Massachusetts Department of Public Health Announces New Initiative to Advance Racial Equity

Blog | April 11, 2024

Blog | March 20, 2024

Podcast | February 20, 2024

Voices in Health Law Podcast: Future Coverage Trends Are in Doubt as 16 million Medicaid Enrollees Have Been Dropped

Podcast | February 02, 2024

AHLA's Speaking of Health Law: Top Ten 2024: Fraud and Abuse Issues to Watch

Podcast | January 22, 2024

Value-Based Care Insights: How Post-Acute Strategies Can Pave the Way for Successful Value-Based Care Integration

Blog | December 27, 2023

Legal Updates | October 30, 2023

Medical Financing Disclosure Bill Introduced in Illinois

Articles | September 01, 2023

Blog | August 28, 2023

Blog | August 15, 2023

Podcast | July 06, 2023

Lisa Luetkemeyer Appears on Candid Care podcast to Discuss ESG in the Healthcare and Human Services Industry

Articles | June 02, 2023

Blog | May 17, 2023

Blog | March 13, 2023

Legal Updates | January 13, 2023

A New Era in Healthcare Cost Regulation in California

Legal Updates | July 19, 2022

CMS Releases CY 2023 OPPS and ASC Proposed Rule

Podcast | June 23, 2022

Lumina Health Partners: Decoding Legalese of Value-Based Contracts

Legal Updates | June 15, 2022

340B Medicare Reimbursement Cuts Ruled Unlawful by Supreme Court

Legal Updates | June 10, 2022

CMS Imposes First Price Transparency Rule Penalties

Podcast | May 16, 2022

AHLA's Speaking of Health Law: Choose Your Own Adventure Guide: Considerations for Physicians Entering into Partnerships

Blog | April 25, 2022

Blog | March 25, 2022

Blog | March 11, 2022

Legal Updates | February 24, 2022

Texas District Court Vacates Portions of No Surprises Act Rule Related to Arbitration

Blog | February 15, 2022

Podcast | January 21, 2022

AHLA's Speaking of Health Law: Top Ten 2022: Pandemic-Related Enforcement and Oversight

Blog | November 18, 2021

Legal Updates | November 05, 2021

CMS Releases OPPS and PFS Final Rules

While there are no surprises in the latest rulemaking, there is some cause for concern for healthcare providers.

Blog | November 05, 2021

Blog | November 04, 2021

Podcast | October 25, 2021

Provident's Healthcare Dealcast: Considerations When Selling a Healthcare Organization: How to Prepare and What to Expect (Ep. 16)

Blog | October 14, 2021

Blog | September 15, 2021

Legal Updates | September 14, 2021

Healthcare Providers to Receive $25.5 Billion in Relief Funds

Blog | September 13, 2021

Blog | August 02, 2021

Blog | July 30, 2021

Blog | July 06, 2021

Legal Updates | June 17, 2021

Provider Relief Fund Update: HHS Changes Reporting and Use of Funds Deadlines

Blog | May 20, 2021

Articles | May 11, 2021

Blog | May 06, 2021

Blog | May 04, 2021

Blog | April 29, 2021

Blog | April 27, 2021

Blog | April 15, 2021

Blog | April 02, 2021

Articles | March 10, 2021

Blog | March 01, 2021

Legal Updates | February 23, 2021

Missouri Senate Advances COVID-19 Liability Protection Bill

Legal Updates | February 11, 2021

The "No Surprises Act:" How Does It Affect Employer-Sponsored Health Plans?

Blog | December 15, 2020

Blog | October 26, 2020

Blog | October 23, 2020

Blog | October 06, 2020

Blog | October 05, 2020

Blog | September 23, 2020

Legal Updates | September 21, 2020

HHS Releases New Details on Provider Relief Fund Reporting Requirements

Blog | August 21, 2020

Legal Updates | August 18, 2020

HHS Reporting Requirement Delay Continues

Podcast | August 05, 2020

COVID-19 Hospice How-To Series: Hospice Physicians are Being Tested by COVID-19, and Increased Scrutiny Lies Ahead—What to Expect and What to Do

Blog | August 05, 2020

Blog | July 29, 2020

Legal Updates | July 21, 2020

HHS Begins Clarifying Reporting Requirements for Provider Relief Funds

Legal Updates | July 16, 2020

Deadline Approaching for Dental Provider Relief Funds

Blog | June 25, 2020

Blog | June 24, 2020

Speaking Engagements | March 25, 2025

Speaker, "Criminal Charges in Healthcare: When the Entity is Held Accountable for Individual Wrongdoing," Strafford Webinar

Speaking Engagements | February 24, 2025

Speaker, "Thriving Independently: Strategic Pathways for Rural Hospitals," AHA Rural Health Care Leadership Conference

Speaking Engagements | February 4, 2025

Speaker, "SNF Involuntary Discharges: Legal Requirements and Practice Tips (SNF)," AHLA Long Term and Post-Acute Care Law and Compliance

Speaking Engagements | February 4, 2025

Speaker, "Case Law Update and Impacts on Long Term and Post-Acute Care Providers," AHLA Long Term and Post-Acute Care Law and Compliance

Seminars | October 29, 2024

Physicians Transactions: Positioning Your Group for Long-Term Success

Speaking Engagements | October 11, 2024

Speaker, "Ask the Expert: The Business of Medical Practice (Ethics)," Texas Medical Association: Business of Medicine Conference

Speaking Engagements | September 26, 2024

Speaker, "Recent Developments in Reproductive Health Delivery," ABA Healthcare Delivery & Innovation Conference

Speaking Engagements | August 28, 2024

Speaker, "Violence in the Workplace," Wyoming Hospital Association Annual Meeting

Speaking Engagements | May 22, 2024

Speaker, "Making Sense of the Post-Dobbs World: Legal Developments on Abortion in Wyoming and Beyond," Wyoming Hospital Association

Speaking Engagements | May 3, 2024

Speaker, "When Healthcare Providers Need to Interact with Law Enforcement," WSHRM Spring 2024 Conference

Speaking Engagements | April 2, 2024

Speaking Engagements | February 6, 2024

Panelist, "Integrated Care Models that Address Complex Discharges Found in Academic Medical Centers," AHLA Advising Providers: Legal Strategies for AMCs, Physicians, and Hospitals Program

Speaking Engagements | April 17, 2023

Speaker, "Fraud, Abuse, & Enforcement," 2023 Georgia Academy of Healthcare Attorneys Annual Meeting and Health Law Update

Webinar | December 2020

Planning, Building and Operating Senior Living Facilities in the Wake of COVID-19

Webinar | August 2020

Contact Tracing and Campus Testing

News Releases | June 11, 2025

С��Ѽ��Ƶ Earns 19 Practice Rankings in 2025 Edition of The Legal 500

Media Mentions | March 25, 2025

Media Mentions | January 26, 2025

Media Mentions | October 15, 2024

News Releases | July 31, 2024

С��Ѽ��Ƶ Guides Consortium of Wisconsin-Based Orthopedic Practices in Sale to Surgery Partners

News Releases | June 12, 2024

Legal 500 Recognizes 16 С��Ѽ��Ƶ Practices, Shortlists Two Others in 2024 Guide

Media Mentions | May 06, 2024

Media Mentions | September 27, 2023

News Releases | September 25, 2023

С��Ѽ��Ƶ Expands Nationally Recognized Cannabis Team with Addition of Partner Hilary Bricken

News Releases | August 11, 2023

Jonathan Porter Named Fellow of American Bar Foundation

News Releases | June 12, 2023

The Legal 500 Recognizes 14 С��Ѽ��Ƶ Practices in 2023 Rankings

Media Mentions | May 08, 2023

Media Mentions | May 05, 2023

Media Mentions | April 14, 2023

Media Mentions | April 13, 2023

News Releases | April 13, 2023

С��Ѽ��Ƶ Adds Former Massachusetts Department of Public Health General Counsel Rebecca Rodman

News Releases | October 06, 2022

David Hilgers To Receive Distinguished Service Award From the State Bar of Texas Health Law Section

Media Mentions | September 09, 2022

Media Mentions | September 08, 2022

Media Mentions | September 07, 2022

Media Mentions | August 01, 2022

News Releases | June 29, 2022

Eleven С��Ѽ��Ƶ Practices Net Rankings in 2022 Edition of The Legal 500

News Releases | May 11, 2022

Julian Rivera Receives ABA Health Law Section Champion of Diversity & Inclusion Award

News Releases | May 10, 2022

Laura Greene Honored as Litigation Practitioner at Missouri Lawyers Media Women's Justice Awards

News Releases | May 10, 2022

С��Ѽ��Ƶ Expands Los Angeles Office and Welcomes Kevin Khachatryan to Healthcare Litigation Team

Media Mentions | May 09, 2022

Media Mentions | April 18, 2022

Media Mentions | April 07, 2022

Media Mentions | April 01, 2022

News Releases | April 01, 2022

С��Ѽ��Ƶ Adds Two Healthcare Partners to Virtual Office

С��Ѽ��Ƶ is pleased to announce that Lisa T. Thomas and Bryan Stewart have joined the firm’s Healthcare, Life Sciences & Education industry group as partners.

Media Mentions | March 30, 2022

Media Mentions | March 28, 2022

Media Mentions | January 16, 2022

News Releases | December 07, 2021

Lowell Pearson Honored as a 2022 Lawyer of the Year by Missouri Lawyers Media

News Releases | November 22, 2021

Morgan Goulet Joins С��Ѽ��Ƶ's Providence Office

С��Ѽ��Ƶ is pleased to announce that Morgan Goulet has joined the firm as Senior Counsel in its Providence office.

News Releases | December 11, 2020

С��Ѽ��Ƶ's Geraci Named to 2020 BTI Client Service All-Stars

Media Mentions | December 04, 2020

News Releases | August 12, 2020

Hal Katz Becomes Chair of ABA Health Law Section Council

Related areas of focus:

340B Drug Pricing Program Academic Medicine Digital Health Healthcare Healthcare Insolvency & Bankruptcy Healthcare Labor & Employment and Immigration Healthcare Litigation Healthcare M&A, Joint Ventures, and Other Transactions Healthcare Operations Healthcare Real Estate Healthcare Regulatory & Compliance Counseling Hospice & Palliative Care Hospice Medicare & Medicaid Audits Medicaid Reimbursement Strategies Medical Staff & Governance No Surprises Act Pharmacy

Key Contact

Curt J. Chase

Partner

View our entire team

“

The С��Ѽ��Ƶ team members we have worked with are valued partners. We could not do what we do without them. We have worked with the Boston-based group for several years, and the impact of national experience on matters like healthcare fraud and abuse has been a real added value. The attorney team knows our business, they know us, and their knowledge and practical experience cannot be overstated.

Senior vice president and chief legal officer, not-for-profit integrated health system