Disputes in the health care industry can arise in a variety of contexts contract breaches, employment issues, practice disbanding, insurance payment and coverage, fraud and abuse and licensing issues.
As health care attorneys representing the interests of clients in the health care industry, our practice members routinely counsel and represent clients in connection with these matters. Services vary from counseling and representing clients in dispute avoidance, mediation, arbitration, administrative investigations and hearings, grievance procedures, lawsuits and appeals. Our attorneys have years of experience and success in resolving matters before litigation as well as aggressively representing clients in litigation, if and when necessary.
Medical Research and Biotechnology
The accelerating pace of development of new drugs and medical devices has created exciting new opportunities for health care providers, entrepreneurs, pharmaceutical companies and others. Along with these new opportunities come new challenges, as the law struggles to keep pace with science. In conjunction with the firm’s intellectual property practice and others, members of the health law department work with physicians, institutions, site management companies, research organizations, medical staffs and others to identify and resolve legal issues arising from the tide of medical research and biotechnology.
Our experience includes:
- Negotiating and drafting clinical trial agreements with sponsors, institutions, CROs and principal investigators;
- Representing physicians involved in post-graduate training programs and related research projects;
- Advising clients regarding compliance with institutional review boards (IRBs), the Food and Drug Administration (FDA) and the Office for Human Resource Protections (OHRP) requirements, including requirements relating to participant informed consent; adverse events; and conflicts of interest;
- Representing principal investigators in negotiations with sponsors and institutions;
- Advising medical staffs regarding the establishment of privileging criteria for new technology and new applications of existing technology;
- Assisting clients in the development of policies and procedures designed to minimize fraud and abuse liability in connection with billing practices in clinical trial;
- Representing providers accused of unprofessional conduct in connection with experimental treatment;
- Structuring research joint ventures between physicians and other health care providers;
- Educating and advising clients regarding HIPAA compliance in the research setting.
Medical Staff Relations
In recent years, medical staffs have recognized the importance of independent legal counsel to provide advice in an increasing number of areas in which their interests may not coincide with the interests of hospital administration. Our attorneys have years of experience representing medical staffs on the full range of issues affecting the relationship with the hospital, and regularly represent them in connection with credentialing, peer review and corrective action processes. Since we do not represent hospitals, we avoid the legal, business and political conflicts of interest that arise when one law firm represents parties on both sides of these issues.
Our experience includes:
- Drafting and revising medical staff bylaws; department rules and regulations; fair hearing plans; and credentialing manuals;
- Developing and drafting of policies and procedures relating to physician health/impaired physicians; disruptive behavior; peer review; quality management and utilization management; credentialing for new technology and new applications of existing technology; information sharing; and fraud and abuse compliance;
- Representing medical staffs in peer review investigations; summary suspensions; the fair hearing process; and other types of corrective action;
- Counseling medical staffs involved in negotiations and conflicts with hospital administration on issues including: economic credentialing and conflicts credentialing; emergency department call coverage and EMTALA; control over bank accounts; and autonomy;
- Advising leadership on compliance with JCAHO standards; Health Care Quality Improvement Act and National Practitioner Data Bank obligations; and state medical board reporting obligations.