Hospitals, Healthcare Providers & Suppliers

Intensified competition, ongoing mergers and acquisitions, evolving regulatory changes, a heightened focus on patient engagement, increasing costs with decreasing reimbursement and emerging technologies are among the numerous factors transforming how hospitals and healthcare providers must adapt to operate effectively and meet patient expectations.

Arnold & Porter has long been a recognized leader in the healthcare industry. Our team includes a deep roster of seasoned lawyers and senior professionals that bring decades of clinical and industry expertise to our clients, including former government officials from regulatory and enforcement agencies such as the U.S. Department of Justice (DOJ), the U.S. Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS) and the U.S. Food and Drug Administration (FDA).

Our attorneys and healthcare policy experts represent hospitals and health systems, hospice, home health care and skilled nursing providers, healthcare professionals, outpatient ancillary service suppliers as well as many national medical societies and industry associations that represent healthcare providers and suppliers.

Integrated Team

A key to our success is our integrated approach. Our team brings together deep experience in transactional, regulatory, and litigation matters to deliver holistic, practical strategies that align with business goals, whether addressing daily operational issues, developing long-term business strategies, or defending against significant enforcement threats.

Comprehensive Services

We advise hospitals and healthcare providers across a wide array of critical areas, including healthcare transactional matters such as M&A, joint ventures and physician-contracting; reimbursement challenges, financial restructuring; regulatory compliance; investigations and litigation; privacy and security; hospital operations; labor and employment; real estate; and legislative and policy guidance.

Representative Experience

Regulatory, Government Enforcement, and Reimbursement

• Newark Beth Israel Medical Center and its parent RWJBarnabas Health in conducting an independent investigation, responding to multiple federal and state enforcement investigations and regulatory reviews, and overseeing the response to extensive media scrutiny and congressional and legislative inquiries following allegations in the national press that patient care in the hospital's heart transplant program was compromised to improve survival statistics.
• Wanaque Center for Nursing and Rehabilitation in its response to a deadly viral outbreak by conducting an independent investigation of the facility's response, responding to investigations, reviews, and enforcement action by multiple law enforcement and regulatory agencies, representing the facility in ongoing litigation with the Centers for Medicare and Medicaid Services, and coordinating the overall response to the media and the state legislature.
• Former hospital chain in defense of a criminal and civil investigation of more than 20 hospitals involving allegations under the federal Anti-Kickback and Physician Self-Referral Laws and inappropriate billing for services.
• Academic medical center in regulatory counseling related to development of xenotransplant program.
• Academic medical center internal investigation of research misconduct
• Outpatient treatment center and referring physician in an internal investigation and OIG voluntary disclosure
• Healthcare provider and suppliers in successful self-disclosures under the Self-Referral Disclosure Protocol.
• Healthcare professionals in defense of OIG exclusion from federal health care programs.
• Academic medical center in high-profile EMTALA case involving CMS and OIG.
• Large hospital system in reimbursement counseling related to Medicare billing for ambulance transports, hospital services related to non-covered/experimental patients services and follow-on post-hospital extended care services.
• Multiple clients in advocacy regarding the hospital IPPS and OPPS payment systems, with emphasis new technology and pass-through payments, MS-DRG and APC assignments, coding, and item/procedure coverage and payment.
• Several children’s hospitals in federal legislative advocacy

Transactional

• A critical access hospital in a membership substitution transaction with a regional health system.
• A community hospital in the sale of substantially all its assets and the establishment of a joint venture with a publicly traded hospital management company.
• A tax-exempt nonprofit hospital in a membership substitution transaction with a large academic medical center.
• Regional health systems in connection with the purchase of certain assets and the negotiation of an exclusive hospital professional services contract.
• Large six-state physician practice with multiple ambulatory surgery centers in a significant reorganization for Physician Self-Referral Law compliance.
• A leading provider of dialysis services and products and a national leader in vascular specialty services in regulatory advice regarding physician joint ventures.
• Various medical, dental, eyecare, and dermatology physician practices in employee benefits and compensation aspects of sale transactions with portfolio companies of private equity buyers.

Litigation

• Multiple hospital systems in data breach litigation
• Several hospital systems in antitrust matters
• Several hospital systems in employment litigation
• Health system in medical faculty violations