Health Care
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As the new millennium ushers in an era of technological change, amazing clinical research, advancement in telemedicine, concerns regarding privacy and confidentiality of individual health information, and increasing regulation at both the state and federal levels, the health care industry will continue to need sophisticated and unique legal advice. Attorneys in the Troutman Sanders Health Care Practice Group offer clients exceptional legal and practical insight on health law matters.
The Troutman Sanders Health Care Practice Group serves the legal needs of a diverse array of health care providers and associated organizations, as well as suppliers of goods and services to the health industry. The Firm's health care practice clients include, among others, academic medical centers, hospitals, integrated health care delivery systems, physicians, physician group practices, provider and practitioner networks, ambulatory surgery centers, nursing homes, home health agencies, rehabilitation agencies, mental retardation facilities, independent diagnostic testing facilities, durable medical equipment suppliers, renal dialysis providers, management companies (including managers of hospitals, home health agencies, rehabilitation agencies, and physician practices), assisted living and personal care homes, consulting entities, health maintenance organizations and other managed care organizations, medical technology companies, and insurance companies. The Health Care Practice Group is not constrained by geographical boundaries, and serves clients throughout the entire nation.
The Firm has consciously chosen to represent a broad spectrum of health industry clients rather than focusing on narrow market segments. This strategic decision enhances the total level of service that the Firm can offer current and future health care clients.
Health Care Regulation
Frequently, business operations and transactions involving health industry clients are driven by compliance with the complex web of state and federal statutes and regulations that govern the health industry. Also, enforcement initiatives in the health industry place all organizations, and many individuals, at risk.
Troutman Sanders has substantial experience in providing regulatory advice to its wide variety of health care clients, including advice related to the Medicare and Medicaid Anti-Kickback Statute, prohibitions against physician self-referral under both the federal "Stark" law and similar state laws, the federal False Claims Act and similar state statutes, Medicare and Medicaid reimbursement and related appeals, certificate of need proceedings and appeals, and licensure and certification proceedings. Troutman Sanders also has experience in the implementation of Corporate Compliance Plans that conform with the Federal Sentencing Guidelines. Firm attorneys have implemented Corporate Compliance Plans for integrated health care delivery systems, hospitals, home health agencies, comprehensive outpatient rehabilitation facilities, rehabilitation agencies, independent diagnostic testing facilities, and nursing homes, as well as for suppliers of goods and services to the health industry.
The Firm is proactive in its approach to regulatory compliance. Our belief is that it is best to assess regulatory risk and seek the guidance of state and federal regulatory authorities before commencement of an arrangement that could put either individuals, entities, or investors at risk. In this spirit, the Firm has assisted clients in obtaining two Advisory Opinions from the Department of Health and Human Services, Office of the Inspector General regarding possible application of the Medicare and Medicaid Anti-Kickback Statute to two separate business arrangements, including the Advisory Opinion on "gainsharing" between a hospital and cardiovascular surgeons.
In the current regulatory environment, all providers and suppliers to the health industry are susceptible to government audits and investigations. Troutman Sanders has experience in providing advice related to grand jury subpoenas, search warrants, and other investigative techniques, as well as complete defense of allegations of wrongdoing.
Mergers and Acquisitions
As a result of a number of forces -- most notably declining reimbursement rates from third party payors, operating inefficiencies, increasing costs of operation, availability of new technology, and industry consolidation -- recent years have seen record numbers of health care mergers, acquisitions, and consolidations. The Troutman Sanders Health Care Practice Group expects this trend to continue as the health care economy recovers from the drastic governmental payment changes implemented in the late 1990's.
A significant part of the Troutman Sanders Health Care Practice involves representing clients in connection with mergers and acquisitions, as well as the formation and financing of new enterprises. For example, the Firm's attorneys have been involved in conceiving acquisition structures to facilitate reimbursement, tax, accounting, business and other specific objectives while being ever mindful of statutory and regulatory compliance. These attorneys have drafted template acquisition documents believed to be among the best crafted, most flexible, and most effective in the industry. The Firm's health care acquisition lawyers are experienced, creative, and effective negotiators.
Medical Technology and Intellectual Properties
The interface between technology and the health care industry occurs on many levels. Technology can be used for electronic data transactions, delivery of tele-medicine services, creation of medical records, monitoring clinical research, generally reducing operational costs of managing an enterprise, or, perhaps most importantly, compliance with state and federal statutes and regulations. The creation or use of all medical technology involves intellectual property protection and related issues. Also, as the health industry becomes more competitive, branding and creation of good will through product or service identity is very important, requiring protection of trademarks and service marks.
The Troutman Sanders Health Care Practice Group includes lawyers with experience in all aspects of intellectual property and technology law, including, among other areas, patent, trademark, tradename, copyright, trade secret, and licensing law. In the patent area, the Firm has specific experience in complex and unique services, such as business method patents and biotech patents.
In addition to health care provider clients, the Firm also represents companies whose primary business is developing and selling medical technology. The Firm's attorneys assist health care provider clients in connection with the acquisition and licensing of medical products, services, and technology, as well as assisting clients in connection with the development, protection, and commercialization of medical technologies.
Capital Financing
Entrepreneurially spirited Health Care Practice Group clients frequently require capital to achieve their objectives. The Firm has helped Health Care Practice Group clients raise equity capital from many sources, including private investors, venture capitalists, and public securities offerings. The Firm has also helped clients with a wide variety of debt financing, including commercial paper and bond financing. Contacts in the investment community, including both venture capitalists and traditional investment banks and lenders, have helped many clients capitalize their business endeavors.
E-Health and Telemedicine
Troutman Sanders Health Care Practice Group members are pioneers in e-health and telemedicine initiatives. Not only does the Firm advise clients on substantive issues such as licensure, electronic commerce, confidentiality, emerging telemedicine payment issues, and development of technology related to these issues, the Firm's attorneys are also leaders in organizations such as the Georgia Electronic Commerce Association, e-Health Working Group, and the Electronic Commerce Forum. The Firm is poised to help clients in the transformation from an industry that delivers service in a fixed location to one that delivers services directly to its patients.
Privacy and Confidentiality
As advancements in technology and the use of the Internet and other electronic means in health care commerce raise questions regarding disclosure of a person's health information, state and federal laws intended to protect privacy and confidentiality of individually identifiable health care information is rapidly developing. The primary source of regulation in this area is the Health Insurance Portability and Accountability Act of 1996, whose privacy regulations became enforceable on April 13, 2001. HIPAA, however, does not preempt state law, and the state laws may be either currently enforceable or provide greater restrictions than the HIPAA regulations, or both. Troutman Sanders Health Care Practice Group attorneys have substantial experience in privacy issues, including HIPAA regulations, and the Firm is well poised to assist all clients on privacy issues.
Academic Medicine
The Troutman Sanders Health Care Practice Group provides a broad array of advice to academic medical centers. The Firm is general counsel to one leading medical school and special counsel to several others. Services include clinical research protocols, intellectual property protection (including biotech and bioengineering patents), development of faculty practice plans, technology and health care joint ventures, immigration of foreign physicians, and the wide variety of services required by any institute of higher learning.
Tax
Group members include tax attorneys with experience in areas that are particularly important for the health industry, including private benefit and private inurement for tax exempt organizations and related intermediate sanction regulations, joint ventures between profit and not for profit entities, and structuring of health industry transactions and arrangements.
Managed Care
Although many pundits predict the demise of managed care, it is alive and well in most markets. The Troutman Sanders Health Care Practice Group has embraced the challenge of competing in a managed care economy. The Firm has assisted clients in integrating payor and provider entities that can effectively compete for managed care contracts. Specifically, the Group's insurance law qualifications are unparalleled in the Southeast, and the Firm has significant experience in related health care antitrust matters. The Firm has formed and advised health maintenance organizations, provider sponsored organizations, and networks of providers and practitioners that intend to enter into global risk contracts. Contacts with actuarial firms allow the Firm to provide advice regarding the economics of risk contracting.
Physician Employment and Consulting Agreements
The Firm has significant experience in structuring, drafting, negotiating, and enforcing physician employment and consulting agreements including non-competition and non-solicitation covenants and the liquidated damages provisions that are often used to supplement such covenants, as well as omnipresent regulatory compliance concerns.
Health Care Legislation
The Troutman Sanders Health Care Practice Group is actively involved in drafting legislative proposals and amendments, advising clients with respect to legislative strategy, testifying before legislative committees and preparing testimony for clients, lobbying in the legislative process, monitoring pending legislation, and rendering advice regarding the probable legal interpretation and impact of such legislation.
Alternative Dispute Resolution
A constant in the managed and regulated health care environment is conflict among multiple parties and interests. Parties to health care disputes, however, are turning away from the courts in search of less costly, quicker, and more user-friendly resolution procedures. Delays, high cost and inflexible remedies are not the most effective means of resolving many health care disputes. Compared to the courts, the advantages of ADR can be particularly attractive. These advantages include: efficient use of time and money and less diversion of other assets; binding but non-precedent outcomes; privacy and confidentiality; the possibility of preserving business relationships; and the avoidance of run-away juries.
Health Care Litigation
When our clients need to bring actions in the courts, the Group's health care litigators provide the Firm's clients with substantial experience in the investigation, negotiation, and trial of a wide variety of health care related disputes, including staff privileges, antitrust, restrictive covenants, service contracts, constitutional challenges to federal regulations, insurance coverage, and proper reimbursement under government payment programs.
Employee Benefits and Compensation
The Group's large team of employee benefits attorneys has a great deal of experience in representing health industry enterprises in all types of employee benefit and executive compensation matters.
Resources of Troutman Sanders
The Troutman Sanders Health Care Practice Group benefits significantly from the exceptional resources of a rapidly growing law firm. Health care clients have taken advantage of the Firm's preeminence in other legal disciplines such as litigation, real estate, and general corporate law. The Firm stands ready to organize the right team of attorneys from among resources in all offices to meet client needs in any market.
Mission
The overriding mission of the Troutman Sanders Health Care Practice Group is to provide health industry clients with sophisticated, responsive, and cost-effective legal advice and planning.
The Group will continually endeavor to expand resources and areas of expertise to meet the changing needs of clients and the ever-increasing complexity in the health care industry as a whole. Firm attorneys welcome the opportunity to meet with prospective clients to further discuss the Health Care Practice Group.