Health Care
Williams Mullen represents hospitals, health systems, and academic medical centers; physicians and other licensed providers and their respective groups; diagnostic imaging providers; home health and hospice providers; post-acute and long-term care providers; behavioral health providers; substance use disorder providers; ambulatory surgery centers (ASCs); payors; management services organizations; and a broad range of others in the health care industry.
We serve as outside general counsel for many clients, advising on the full range of legal matters that arise daily. For other clients, we complement in-house legal teams, bringing enhanced experience to complex regulatory, transactional, and operational matters. We are routinely engaged as a “trusted advisor” for both business and legal issues.
We have a keen understanding of the health care market and our clients’ business needs, which we use to help clients develop practical, workable, and legal strategies.
Our experience includes:
Transactions
Williams Mullen helps health care providers enhance their capabilities, increase their capacity to serve a wider patient population, and provide exceptional patient care via mergers, acquisitions, joint ventures, strategic affiliations, financing, and management agreements.
We leverage our industry knowledge, extensive health care regulatory experience, and deep bench of attorneys in critical practice areas such as employment, tax, employee benefits, corporate, finance, intellectual property, and real estate to provide comprehensive legal solutions to health care clients engaged in a transaction.
Corporate Governance and Operations
Our attorneys partner with clients to provide counsel on governance, contracts between providers (including physician groups and hospitals), management and services agreements, employment agreements, medical staff matters, health care reimbursement, incident response, and credentialing and disciplinary matters.
We also assist with contracts for the procurement of medical devices, products, technology, and pharmaceuticals, including advising on relationships with group purchasing organizations.
Certificate of Public Need (COPN) and Certificate of Need (CON)
Providers across the health care delivery spectrum rely on Williams Mullen to help them identify and act on opportunities to develop services and medical care facilities in jurisdictions with COPN/CON requirements, including Virginia, North Carolina, Florida, and Washington, D.C. Our experience is comprehensive, ranging from early-stage strategy to application drafting to hearings and appellate litigation.
Federal Regulatory
We advise on the full range of health care fraud and abuse laws, including the Stark Law, the Anti-Kickback Statute, the False Claims Act (FCA), and the Civil Monetary Penalties Law (CMPL), as well as Medicare enrollment and reimbursement requirements, and related investigations and litigation.
Privacy and Data Security
We have extensive experience with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 42 CFR Part 2 (regarding Substance Use Disorder (SUD) records), and state law. Our attorneys assist clients with policies and procedures, training, breach response, subpoena requests, and complex disclosure issues involving SUD information, risk of harm concerns, and health information related to public safety on college campuses.
State Regulatory
We help health care providers with facility and professional licensure and certification, Medicaid enrollment and reimbursement, and state self-referral laws, and related investigations and litigation, including disciplinary board matters.
Medicaid Reimbursement
Williams Mullen has significant experience with Virginia’s Medicaid program and routinely assists providers seeking to enroll in Medicaid and with the credentialing process with Medicaid Managed Care Organizations (MCOs). Our attorneys work closely with providers to give counsel on cost reporting, payment methodologies, and reimbursement strategies. We regularly advise clients facing audits, overpayment investigations, and recoupment actions. We also have substantial experience defending informal and formal appeals.
Medicare and Medicaid Certification and Surveys
We represent entities and professionals navigating the Medicare and Medicaid certification and survey processes, including challenging survey deficiencies through informal dispute resolution conferences, and various accreditation matters for entities and individual providers.
Compliance Plans and Policies
We assist with compliance plan development, internal training, auditing, and policy reviews. Our experience includes corporate compliance plans; fraud, waste, and abuse training; adverse event reporting and tracking; and evaluation of billing practices, including responses to overpayments.
Government Relations
We assist with both executive and legislative matters that impact health care providers and have been instrumental in establishing laws and precedents that have state-wide impact.
