We represent hospital-based groups of every size, from small practices to very large groups with hundreds of physicians and advanced practice providers. Among the services we provide are the following:

Formation and structure. We structure and form the entities through which hospital-based groups operate. We also restructure established groups whose original architecture no longer fits their size, their market, or their goals.

Governance.Many of a group’s problems trace back to how it makes decisions. We design intragroup management structures and allocate rights and responsibilities among owners, directors, officers, and managing members. The aim is for the group to act as a business, not a club.

Physician and professional relationships. We plan and prepare employment agreements and subcontracts with group physicians and other healthcare professionals.

Facility relationships. For a hospital-based group, its exclusive contracts are its most valuable assets and its greatest vulnerability. We negotiate and draft exclusive contracts with facilities ranging from small surgery centers to community hospitals to internationally renowned medical centers to across healthcare-systems. We guide financial support/compensation negotiations and responses to RFPs. We also counsel groups on managing the facility relationship over the life of the contract, including the risks created by hospital leadership turnover, indemnification and insurance provisions, and competition from other groups seeking to take over the contract.

Medical staff issues. We represent medical staff departments and department physicians in matters involving medical staff privileges and discipline.

Payors, vendors, and management entities. We negotiate arrangements with payors. We have particular experience in designing the negotiating complex agreements between hospital-based groups and revenue cycle management (AKA “RCM” or “billing service”) vendors.

Insurance Matters. We provide specialized counsel to hospital-based medical groups in negotiating the terms of various insurance coverages such as D&O, EPL, cyber liability, and sexual assault.

Compliance. We counsel groups on compliance issues including federal and state anti-kickback laws, Stark and state self-referral laws, HIPAA, and False Claims Act exposure.

Disputes and transitions. We resolve intragroup disputes, from matters such as the withdrawal of a physician, to problems created by disruptive physicians, to “divorces” of groups of very significant size across multiple facilities.

Growth and strategic alternatives/M&A. We design relationships among medical groups, including group-to-group mergers and less-than-full-merger alliances. We also advise groups weighing a sale or acquisition on their best course, whether that’s a transaction or one of several alternatives.

Academic departments. We are experienced in representing hospital-based specialty academic departments on their relationship with medical schools, hospitals, and physician staff.

Residency Programs. We represent non-academic hospital-based specialty groups and medical staff departments in connection with arrangements with medical schools and governmental agencies in regard to residency program sites.

In each of these areas, our work is coordinated with the group’s overall strategic goals rather than handled piecemeal, one problem at a time.