Physician Group Formation
Our firm specializes in assisting physicians in forming new practices whether the group consists of one owner or one hundred. We are experts in advising physicians on how to correctly launch a new business enterprise, including:
- Advice regarding choice of entity
- Assistance in preparation of the basic corporate documents; articles, bylaws, buy/sell agreements, and employment agreements
- Assistance in obtaining all necessary permits including fictitious name, provider number, employee ID number, and business licenses.
Mergers, Sales and Dissolutions
Our firm specializes in assisting physicians who are considering or involved in a merger, sale, dissolution or other form of business reorganization. We have provided advice in many diverse situations, including mergers involving independent specialty practices, sales of physicians entering practice and retiring from practice. We also assist physicians in dissolving their practices whether such is the result of a business reorganization or insolvency planning. Such transactions often involve the interplay of a complex spectrum of special regulatory laws, some of which may conflict, including antitrust, Stark II, and fraud and abuse laws.
Joint venturing is often a key to sustaining a viable economic base. We specialize in joint ventures involving different physician groups, physicians and hospitals, and physician groups and other business entities including vendors of all types. Such transactions generally require not only a solid knowledge of traditional business and tax laws but also a sophisticated knowledge of the regulatory laws and statutes in the areas of Stark II and fraud and abuse. We have that knowledge base.
The firm represents its clients in the full range of civil litigation in state and federal court throughout California, including claims for breach of contract, intentional interference with contract and other business torts, defamation, insurance coverage claims, antitrust claims, and other commercial claims.
Our firm represents providers and physician-affiliated payors (like IPAs) in reimbursement disputes. We are knowledgeable in all aspects of reimbursement for medical services from both private and public payors, including contracted and non-contracted arrangements, capitated and fee-for-service payment models, coding issues, regulatory requirements, and administrative appeals.
Our firm is uniquely positioned to handle a broad range of employment disputes because we represent both medical group employers and individual employee physicians. We have litigated numerous employment claims, including unpaid wages, enforcement of non-compete and confidentiality clauses, solicitation of patients and employees, and misappropriation of trade secrets. We also provide pre-litigation advice to solve a number workplace challenges without litigation, ranging from hiring and termination decisions to medical leave and disability accommodations.
Physicians and medical groups encounter significant bureaucratic obstacles when contesting a determination made by a Medicare contractor. We help providers navigate the byzantine administrative appeals process for a number of Medicare related issues, including alleged overpayments and recoupment, enrollment complications, and eligibility issues.
California law provides physicians with myriad procedural and substantive rights to challenge the restriction or revocation of a physician’s privileges. We are well-versed in the law of administrative and legal proceedings affecting a physician’s medical staff privileges (including peer review, disciplinary hearings, and fair procedure litigation) and we are committed to ensuring that physicians get a fair shake.
Our attorneys regularly advise physicians and medical groups in disputes with third parties, including vendors, governmental agencies, insurance companies, healthcare service plans, and hospitals. We are experienced in assuring that appropriate due process guarantees are extended to our clients. In all such disputes, we will take a hard look at the merits of the dispute before accepting such representation.
We are general legal counsel for the California Society of Plastic Surgeons and the California Radiological Society. We are also general and special counsel for IPAs, including being outside counsel for Brown & Toland, a fifteen hundred member IPA in San Francisco and medical staffs. In that regard, we regularly advise such organization on membership problems and disputes, due process, bylaws, corporate, securities, and antitrust issues.
We regularly advise clients in matters involving the accreditation of educational institutions. We are general counsel for the Accrediting Commission for Community and Junior Colleges, Western Association of Schools and Colleges. We also advise educational institutions in the areas of due process, hearing code formation, antitrust, and federal and state educational regulation.
anti-kickback, Stark, Speier laws
We regularly advise our clients in negotiating the thicket of often confusing and sometimes conflicting laws and regulations which govern the formation and operation of many types of healthcare ventures, including imaging centers, ambulatory surgery centers, medical office buildings, and similar business structures.
Corporate Practice of Medicine
California is one of only a few states that still enforces prohibitions against lay corporations employing physicians. We are thoroughly conversant with this law, its many applications and exceptions. Appreciation of the law is critical in structuring sales and mergers and management agreements between physician groups and lay entities such as hospitals and MSOs.
Insurance and Risk Management
We regularly advise our healthcare clients on a wide variety of insurance and risk management issues. Our work includes providing advice on insurance policy coverage issues and acting as advocates for our clients in disputes with insurance companies over disputed areas of coverage.