Nationally, we represent hospitals, nursing homes, assisted living facilities, continuing care retirement communities, large and small physician groups, health maintenance and other managed care organizations, non-profit health foundations, professional and trade associations, health care networks, private entities with quasi-regulatory authority, and joint venture entities.

Services
Antitrust
Certificate of Public Need
Corporate Compliance Programs
Federal and State Fraud and Abuse
HIPAA Compliance
HMO Licensing
Health Care Facility and Professional Licensing
Integrated Provider Networks
Intellectual Property
Internal Compliance Investigations
JCAHO Accreditation
Joint Ventures
Labor & Employment
Legal Audits
Litigation
Long-term Care/Assisted Living
Managed Care
Medical Staff
Medicare and Medicaid Certification
Medical Records and HIPAA Privacy
Medicare and Medicaid Reimbursement
Mergers, Acquisitions, Dispositions and Financings
Physician-Hospital Organizations
Physician Self Referral Prohibitions
Securities Offerings
Tax-exempt Organizations

Sample Representations

Hospital Systems

• Development of health care provider affiliations and networks, including the formation of a 50-physician hospital-based integrated delivery system.
• Representation of health care system in a merger, which included hospitals, an integrated delivery system, health maintenance organizations and ancillary providers, in which the resulting entity had revenues of approximately $1 billion.
• Representation of clients in obtaining certificates of public need for hospitals and diagnostic services.
• Development of medical staff bylaws, rules and regulations.
• Development of antitrust law compliance strategy for hospital systems and joint ventures.
• Development of medical office buildings on hospital property.
• Representation of a non-profit hospital in a joint venture with both non-profit and for-profit entities.
• Acquisition and sale of non-profit hospitals to various entities, including a for-profit, publicly-held company and involving tax-exempt organization, charitable trust and bond finance issues.
• Representation of hospitals in contracting with physicians as employees and independent hospital-based physicians, and with respect to recruitment contracts.
• Representation of a non-profit substance abuse treatment center in its negotiations to affiliate with a non-profit hospital system.
• Representation of hospitals in joint ventures with other hospitals, medical staff members and other healthcare providers.
• Negotiation and settlement of fraud and abuse allegations by the U.S. Department of Justice and the Department of Health and Human Services Office of the Inspector General.
• Representation of hospitals in breach of patient privacy and confidentiality.
• Protection of medical records confidentiality in the context of computer databases.
• Representation of hospitals and hospital executives in employment contract negotiations and disputes.
• Representation in peer review proceedings, in the traditional hospital medical staff setting as well as in newer areas such as provider networks and national self-regulatory organizations.
• Representation of health care providers in matters involving computer software development, legal protection and licensing.
• Development of corporate compliance programs for hospitals.
• Government contacting for hospitals and other heath care providers at the federal and state levels.
• Risk management for hospitals and other health care organizations.
• Organization and operation of ambulatory surgery centers.

• Representation of financial purchaser in the acquisition of 53 nursing home and assisted living facilities in the state of Florida from the largest public company involved in skilled nursing facilities in the U.S., resulting in a transaction valued at over $225 million financed by national institutional parties. Handled complicated regulatory, real estate, finance and taxation issues simultaneously to secure successful closure on tight deadline. Resulted in one of the largest single transactions of its kind in any one state.
• Representation of a long-term care operator in the acquisition of over 20 skilled nursing facilities, ALFs, ILFs, and CCRCs from a public company in bankruptcy in a transaction valued at over $100 million.
• Representation of purchaser in the acquisition of 11 nursing home and assisted living facilities in the state of Florida from a public company on behalf of a private REIT, using GECC for senior term debt and international institutional equity capital in a transaction valued at $27 million, and the concurrent triple net leasing of same to an experienced operator.
• Representation of a long-term care operator in developing, financing, constructing and operating 40 long-term care facilities.
• Representation of a long-term care provider in the sale of 18 nursing homes in Tennessee and North Carolina and 2 ancillary businesses (IV and PT therapy) to a publicly traded company in a transaction valued at over $100 million.
• Representation of a long-term care operator in developing, financing, constructing and operating 50 skilled nursing facilities, ILFs and CCRCs nationally.
• Representation of a not-for-profit continuing care retirement community that is in the process of expanding its skilled nursing facility and developing an assisted living facility and floating tax-exempt bonds in order to finance its projects.
• Advising nursing facilities on Medicare and Medicaid reimbursement matters and prosecuting reimbursement appeals.
• Representation of nursing facilities on licensure and certification matters, including defense of civil monetary penalty assessments, license revocation hearings, Medicare and Medicaid provider contract termination proceedings.
• Development of personnel manuals with nursing facility management.
• Development of patient admission documents including admission contracts and binding arbitration clauses covering payment disputes and medical malpractice claims.
• Representation of nursing facility providers in the development of new facilities from the certificate of public need application to construction and permanent financing, to license and certification.
• Representation of nursing home administrators on licensure matters before the Board of Nursing Home Administrators.
• Organization of business entities (C Corporations, S Corporations, limited partnerships, limited liability companies and joint venture organizations for the operation, management and acquisition of nursing facilities and assisted living facilities.
• Representation of Virginia long-term care providers in the acquisitions or sale and financing of nursing home facilities and assisted living facilities and ancillary businesses for both privately and publicly held companies in various transactions with a collective value in excess of $200 million.

• Representation of physician groups in mergers, restructuring and billing company disputes.
• Development of antitrust law compliance strategy for physician groups and joint ventures.
• Negotiation of affiliation agreements with physician practice management companies for physician groups.
• Representation of physician groups in the restructuring and termination of affiliations with physician practice management companies and development of alternative management arrangements.
• Representation of physicians before state licensing and regulatory boards.
• Organization, capitalization and operation of a multi-state system of 19 urgent/primary care centers.
• Development and operation of physician-controlled management service organizations.
• Organization and operation of ambulatory surgery centers.

• Representation of hospitals, health systems and physician-hospital organizations in managed care contracting and dispute resolution including litigation and complaints to the Bureau of Insurance.
• Representation of a NYSE corporation in the stock acquisition of a Florida Medicaid HMO in a transaction valued at $124 million.
• Representation of hospital associations in challenges to Medicaid reimbursement systems and methodologies which resulted in excess of $130 million in new reimbursement to hospitals and adoption of new reimbursement system.
• Advise providers on insurers' obligations under and compliance with the Ethics and Fairness in Carrier Business Practices Act.
• Development and operation of health maintenance organizations and representation of HMOs in sales and purchases.
• Lobbying in the Virginia General Assembly regarding health care facility and professional provider reimbursement and regulation, managed care issues and health care competition issues.

Attorneys
R. Brian Ball 
Wyatt S. Beazley IV 
John C. Bilzor 
James A. Blalock III 
James M. Burns 
Clifford A. Coppola 
Patrick C. Devine, Jr. 
Arlene J. Diosegy 
Martin A. Donlan, Jr. 
Harold Hak Beom Han 
Marcus C. Hewitt 
Jessica S. Jones 
Samuel M. Kroll 
Derek W. H. Kung 
Amanda L. Kutz 
Jennifer A. Morgan 
Malcolm E. Ritsch, Jr. 
Lawrence R. Siegel 
Albert J. Taylor, Jr. 
Charles E. Wall 
Roy H. Wyman, Jr.  

Articles
IRS Issues Final Intermediate Sanctions Rules
Federal Self-Referral and Anti-Kickback Laws: A Primer for the General Business Lawyer
Changes in the Works to SMFP to Determine Need for New Operating Rooms
Non-Professional Corporation Restrictive Covenants in Jeopardy
Recent SMFP and Legislative Developments in Virginia’s Certificate of Public Need Law
FTC Issues Significant New Advisory Opinion on Clinical Integration
Changes to Stark Regulations
House Judiciary Antitrust Task Force Holds Hearing on Pharmacy Antitrust Bill
UnitedHealth/Sierra Merger Permitted to Proceed, With Conditions
Overview of North Carolina Certificate of Need Law
Noncompetition Agreements Collide with Virginia's Corporate Practice of Medicine Doctrine
2006 Decision by DFS Effectively Lowers Cost Thresholds for Projects Requiring CON’s
FTC Seeks to Block Northern Virginia Hospital Merger
Recent decision may cause more stringent application of who constitutes an “affected person” with the right to appeal an Agency decision

Contact
Malcolm E. Ritsch, Jr., Co-Chair
Two James Center
1021 East Cary Street (23219)
P.O. Box 1320
Richmond, VA 23218-1320
Phone: (804) 783-6486
Fax: (804) 783-6507
dritsch@williamsmullen.com

Lawrence R. Siegel, Co-Chair
222 Central Park Avenue, Suite 1700
Virginia Beach, VA 23462-3035
Phone: (757) 473-5321
Fax: (757) 473-0395
lsiegel@williamsmullen.com