Hospitals and Health Systems

Owners and operators of hospitals and other healthcare facilities are faced with a wide range of legal and operational challenges in an ever-changing environment. Getting legal guidance that will help you to be efficient, compliant and proactive is essential for your organization's health.

Strategies and Insights for Your Organization

At Holland & Knight, our goal is to provide you with the counsel, strategies and insights you need to ensure that decisions made in your hospital's legal environment are well-informed. We apply our industry savvy, understanding of corporate law and public company legal know-how to your organization's needs in our commitment to help you be successful – so you can focus on the delivery of healthcare services. The strengths of our healthcare team, one of the largest and most sophisticated in the U.S., include:

• nearly 100 years of healthcare practice, representing our clients’ interests in virtually every area of hospital law and public health law
• lawyers who bring a diverse range of real-world industry experience to your issues – with backgrounds that include serving as in-house hospital counsel, hospital trade association counsel and government-level policymakers
• legal representation that includes not-for-profit hospital chains; Section 501(c)(3) hospitals, such as systems affiliated with religious organizations and public hospital authorities; children’s hospitals; and for-profit hospital corporations

Hospital Operations

Attorneys from our Healthcare Group’s Hospital Practice will advise you in your health benefits arrangements – including your physician-hospital organization development, direct contracting with employers and ERISA plans, network tiering and consumer-directed hospital benefits design. They will help your organization navigate complex EMTALA, patient transfer and patient discharge matters. Careful review of your hospital-physician contracts and vendor agreements is also available as part of our commitment to help you avoid potential legal pitfalls and compliance violations. Our attorneys also provide counsel in the following legal areas:

• managed care contracting
• contracting standards guides for internal executive utilization
• JCAHO compliance
• advanced directives and end-of-life issues
• informed consent and other risk management issues
• clinical laboratory operations – including outreach lab service departments and joint ventures
• medical staff issues such as credentialing, peer review and related dispute resolution
• healthcare provider licensure in all disciplines
• federal and state contracts and grants

Litigation

By drawing in talent from Holland & Knight’s Litigation Practice Group, lawyers from the Healthcare Team's Hospital Practice can help protect your interests in complex litigation matters such as privacy and other class action defense – including disputes with third-party payers and physician groups. When you are facing complex investigation and peer-review proceedings, including fair hearing and litigation involving professional review actions taken, working with lawyers who have extensive experience in general commercial litigation – such as contract disputes with vendors and insurers – is an important step towards helping to ensure a positive outcome. Your Holland & Knight legal counsel is committed to your success and can advise you in connection with a wide range of matters including:

• medical malpractice defense and non-medical personal injury defense
• medical staff representation
• litigation of business disputes that arise out of hospital exclusive dealing or “economic credentialing” decisions
• mediation and arbitration of disputes involving hospital contracting issues
• insurance coverage litigation
• creditors’ rights and bankruptcy

Corporate Compliance

Careful adherence to all compliance requirements not only helps you to avoid violations, but also demonstrates your commitment to ethical practices. Again, our team of dedicated healthcare professionals will collaborate with lawyers from other areas of the firm to bring the right experience to bear on your corporate compliance issues, including the following matters:

• compliance with federal and state anti-kickback laws and defense of “fraud and abuse” claims
• Stark physician self-referral laws, including physician recruiting and other hospital-physician or group practice relationships issues
• HIPAA law compliance, and state privacy and security laws
• internal compliance investigations and representation during disclosures to the government
• Compliance training program development, implementation and enforcement

Enforcement Defense

The cost of enforcement actions often goes well beyond the expense of responding to the allegations, paying the penalty or pursuing corrective action. We recognize that an enforcement action can impact your business in many ways – from investor and customer perception to community relations. We are experienced in defending cases in all major areas of enforcement defense – from Qui Tam litigation to antitrust counseling and litigation. Additional areas in which we can represent your interests include the following:

• defense of audits and investigations
• antitrust counseling and litigation including monopolization claims and claims of unlawful collective restraints
• white collar litigation

Legislative and Regulatory Representation

The healthcare industry operates in a unique legislative and regulatory environment. Holland & Knight’s dedicated Legislative and Regulatory Healthcare Practice consists of seasoned legislative and regulatory attorneys, non-lawyer lobbyists and public relations professionals who bring hands-on experience, depth of practice and industry insight to bear on regulatory matters. We are dedicated to offering the most sophisticated understanding not only of your legal issues, but also the business and political arenas in which your organization operates.

Insurance and Risk Management

Your Holland & Knight team will partner with lawyers from our Health Plans and Health Insurance Group to advise you and help safeguard your hospital system’s interests. You have access to the resources of the firm as well the Healthcare Group’s comprehensive knowledge of health insurance-related matters, including the following:

• assessment of and recommendations concerning existing insurance and risk-management structures and processes
• insurance policy interpretation and coverage opinions
• evaluation of alternative risk management devices, including captives and self-insurance trusts
• representation of your hospital’s interests in insurance receiverships, state-unauthorized insurer administrative action and Department of Labor independent fiduciary proceedings

Finance, Tax and Transactions

Lawyers in our Healthcare Practice are skilled in current areas of special interest to hospital owners and operators – acquisitions, dispositions, affiliations, joint ventures and reorganizations. Leveraging Holland & Knight’s broad-based practice resources, they will provide you with informed representation to support your business strategy in a wide range of matters, including:

• structuring and negotiating bond documentation for taxable and tax-exempt financings
• negotiating derivative transactions including forward agreements, float agreements, interest rate swaps and related transactions
• analyzing tax compliance with Sections 103 and 501(c)(3)
• maintaining tax-exempt status, unrelated business income issues, guidance regarding excess-benefit transactions and employment tax advice

Research and Clinical Trials

The growing number of reported research violations that have resulted from clinical research trials has raised critical questions about how to protect the safety of human subjects. Additional scrutiny and controls may be on the horizon. The Healthcare Team’s Hospital Practice attorneys provide timely and comprehensive counsel to help your organization chart a safe course through the legal, operational and ethical issues associated with clinical research trials. We can help you realize your objectives in the following areas:

• representation of institutional review boards
• informed consent for human research
• sponsored research agreements
• technology transfer and licensing
• clinical trial agreements
• Medicare reimbursement for routine care in clinical trials

Flexible, Integrated Team Support 

 As your organization grows and changes to accommodate emerging economic and policy developments, Holland & Knight’s Hospital Practice attorneys have the experience and industry savvy to continue to provide counsel. Our collaborative, team-based approach taps talent from across the firm to give you the personalized service and senior partner involvement you need from a wide range of additional disciplines that include employment and labor relations; intellectual property; and real estate finance and construction contracting property. We will continue to tailor our services to your evolving requirements in the ever-changing business of healthcare.