Health Care Transaction, Regulatory Compliance & Litigation

Taylor Porter has an integrated, multi-disciplinary health care team with experience in virtually every aspect of health care delivery and financing. Our attorneys provide the full range of legal services necessary for our clients to succeed within a complex and often changing American health care system, full of industry-specific laws, rules, and regulations. Our team advises and counsels clients in the following areas: employment and employee benefits, health information technology, intellectual property, litigation and dispute resolution, medical malpractice, operations, regulatory, risk management, tax planning and compliance, trademarks, transactions.

Our attorneys have experience in a broad spectrum of transactional, regulatory, compliance and litigation related matters, and do crossover work with attorneys across several additional practice area groups, advising corporate commercial clients in the following areas, but not limited to litigation, corporate & transactional, government relations, labor and employment, Medicare Secondary Payer and MMSEA (Section 111) compliance, mergers & acquisitions, intellectual property, tax and white collar defense.

Taylor Porter’s broad range of diverse clients in the healthcare industry include:

• Academic Medical Centers
• Ambulatory Surgery Centers
• Behavioral Health and Mental Health Facilities
• Device and Equipment Manufacturers
• Dialysis Clinics
• HMOs, PPOs, Provider Networks and Other Managed Care Organizations
• Home Health Agencies
• Hospice
• Hospitals and Acute Care Providers
• Imaging Centers
• Long Term Care and Assisted Living Facilities
• Medicaid Managed Care Organizations
• Medical Staffs
• Pharmacies and Pharmaceutical Manufacturers
• Physician Groups and Clinics
• Physicians and Dentists (in both individual and group practice settings)
• Private Nonprofit and For-Profit Hospitals
• Rehabilitation Hospitals
• Software vendors and developers, and data storage parties
• Surgical Hospitals and Ambulatory Surgery Centers

Health Care Litigation – Dispute Resolution:

• Defending claims of medical malpractice, representing physicians, other health care professionals, pharmacists, nurses, etc. in disciplinary and malpractice matters, in licensure and accreditation disputes, and in other professional liability claims.
• Fraud and abuse, including anti-kickback statute, false claims act, self-referrals/Stark, and state law issues.
• Licensure, Certification and Accreditation, including state licensure and agency interface, Medicare, Joint Commission, NCQA, URAC 8. Litigation and Dispute Resolution, Professional Liability, Manufacturer Liability (pharmaceuticals, devices, diagnostic, DME), HCQIA Litigation, and Qui Tam Litigation.
• Medical staff disciplinary actions, due process, and fair hearings, including the issues of bylaws, credentialing and peer review, fair hearing process, HCQIA and state law immunity, and national practitioner data bank issues.
• Provider licensing and certification investigations and litigation.
• Actions brought under the false claims act including qui tam and whistleblower lawsuits.
• Reimbursement appeals before the provider reimbursement review board and in the courts, and healthcare reimbursement areas including Medicare and Medicaid, Managed Care, and ERISA.
• Investigations
• Administrative proceedings
• Alternative Dispute Resolution

Health Care Transactions:

• Business Organizations and Contracts
• Mergers and Acquisitions
• Joint Ventures and “Under Arrangements” Contracts
• Health Care Financing
• Tax
• Antitrust

Regulatory and Compliance Counseling:

• Billing and Reimbursement
• Fraud and Abuse
• EMTALA
• HIPAA
• Clinical Research and Grant Integrity
• Licensure, Certification and Accreditation

Health Information Technology:

• Data breaches and record hacking
• E-health issues and HIPAA privacy and security to protect the information of patients.
• Health information sharing, and the rules and regulations of software, licensing, and technology issues.

Pharmacy Consultation and Representation:

Taylor Porter represents pharmacy owners and managers with issues related to the operation of pharmacies, including business formation, transactions, employment needs, licensing and permits, accreditation, audits and inspections, policies and procedures, reimbursement disputes, CMS compliance, among other legal needs. Several legal representative matters in this field include:

• Assisting pharmacy owners with various issues, from business formation and structuring, to defense of disciplinary issues, and preparation and filing of all necessary business documents.
• Drafting and review of employment contracts, and assistance with the review and negotiation of managed-care organization contracts.
• Assisting with procedural and compliance issues, including obtaining the required state permits, DEA registration and CMS enrollment.
• Preparing policy and procedure manuals to ensure future compliance with State, DEA, HIPAA and CMS regulations.
• Helping pharmacies avoid legal or disciplinary actions for those currently under investigation, action or audit.
• Working with pharmacies on expansion transactions, from planning stage to determining the best business structure for the corporation, given the new location, and considering factors such as risk, liability, tax responsibilities, level of administration, etc., and future goals of the corporation. 

Medical Staff, Credentialing and Peer Review

Health Benefits and Insurance

Medicare and Medicaid Reimbursement

Risk Management and Dispute Resolution