We represent many types of health care organizations and medical and dental providers, providing legal services in the following health care-related areas:

Transactions


Entity Formation

We regularly assists providers to form businesses and entities and elect the appropriate form, including professional corporations and professional limited liability companies. Health care presents certain unique entity formation requirements. For example, both state and federal law limit the extent to which licensed health care providers and non-licensed providers can co-own businesses. Similarly, Washington law restricts the types of entities that certain kinds of health care providers are permitted by law to operate. We have extensive experience drafting partnership, shareholder, membership, and joint venture agreements.

Business and Employment Agreements

We regularly helps health care clients with the drafting, review, and negotiation of health care employment agreements.  Such contracts in the health care industry involve unique issues when compared to other industries. For example, there are special considerations with respect to independent contractor versus employee classification, exempt versus nonexempt status, maintaining salary basis, safeguarding patient information, restrictive covenants and the balancing of patient interests, professional liability insurance, and compliance with state and federal health care laws.

Practice and Facility Acquisitions and Sales

Our attorneys have substantial experience in the purchase and sale of medical, dental, and other health care practices. We use our substantial experience to understand the issues and risks for both buyers and sellers. We work with clients to address the full range of ancillary business issues related to practice sales, including negotiating leases and transitioning practice staff, patients, and contracts. Our deep understanding of Stark, Anti-Kickback, and Washington-specific regulatory issues enables us to offer advice that meets our clients’ needs in this area.

Management Companies

We advise and assist management companies in the drafting and negotiation of management services agreements. We provide regulatory counsel to structure the management arrangement taking into account complex federal and Washington state laws and regulations, including the ban on the corporate practice of medicine, anti-rebate, and fee-splitting prohibitions.

Compliance


Stark / Anti-Kickback

On top of the ordinary business concerns, health care businesses and transactions have to navigate a complex scheme of a web of state and federal restrictions on self-referral and other prohibited economic relationships. For example, the federal Physician Self-Referral Law (Stark) regulations and Anti-Kickback Statute (AKS) must be considered in any arrangement or relationship that involves any Medicare, Medicaid or any federal health care program. In addition, Washington has its own anti-rebate and fee-splitting prohibitions.  The consequences for violating these laws can include criminal and civil penalties and exclusion from participation in federal health care programs. Given the consequences, clients must understand the basic limitations imposed by these laws and their practical application.  We routinely advise clients on the legally allowed relationships with providers, managers, marketers, and other business entities.

Spas / Medical and Non-Medical

We advise a number of clients with respect to the complex intersection of the practice of medicine and related medical spas. Special issues in this area often involve handling cash payments, membership plans or similar offers, proper supervision of lower licensed staff, and ownership or participation in the financial rewards of the business by unlicensed individuals. It is important that these facilities consult our experienced attorneys to help navigate these issues.

HIPAA

We frequently advise our clients on issues related to HIPAA, the Health Insurance Portability and Accountability Act.  Our lawyers enable clients to comply with the security and privacy requirements for health care information. Although HIPAA is used as a catch all phrase for patient privacy, Washington health care providers also need to comply with Washington’s Uniform Health Care Information Act (UHCIA).  Although HIPAA and the UHCIA overlap in many ways, there are many areas in which these two acts diverge, including with respect to scope of coverage. Among other issues, we handle the following issues:

  • Helping clients create and implement HIPAA compliance plans, which the Health Information Technology for Economic and Clinical Health (HITECH) Act requires for both covered entities and business associates;
  • Drafting and negotiating business associate agreements and other HIPAA-compliant contracts;
  • Breach assessment and notification;
  • Responding to patient complaints;
  • Defending lawsuits and administrative proceedings involving these issues; and
  • Serving as HIPAA compliance counsel.

Surgery Centers

We represent a number of ambulatory surgery centers. We regularly counsel and help ambulatory surgery centers on a range of business and regulatory challenges, including:

  • Certificate of need issues (and related determination of non-reviewability issues)
  • Joint ventures
  • Entity formation and partnership agreements
  • Management contracts
  • Lease negotiations
  • Health system contracts
  • Employment agreements and employment law
  • Stark and Anti-Kickback Statute compliance
  • Corporate compliance programs
  • Federal (HIPAA) and state patient data privacy and security requirements
  • Business and employment litigation

Litigation & Regulatory Defense


Medical Staff Privileges

We have been extensively involved in issues related to medical staffs. We represent physicians and other health care providers throughout all phases of medical staff privilege disputes, including investigations, peer review hearings, and appeals.

Employment Disputes

We often represent health care employers and employees with respect to claims of breaches of noncompetition covenants, wrongful termination, breach of employment contracts, harassment, whistleblower complaints, race discrimination, national origin discrimination, sex discrimination, disability discrimination, age discrimination, and other matters.

Professional License Issues

We represent health care professionals and facilities in investigations and enforcement actions concerning such licenses. This can involve navigating physician impairment issues, referrals to the Washington Physicians Health Program (WPHP), and reports to the National Practitioner Data Bank (NPDB). When necessary, we respond to and contest actions of the professional licensing boards under Washington Department of Health (such as the Medical Commission, Dental Quality Assurance Commission (DQAC), etc.). In addition, we advise providers on compliance with statutes, regulations, and policies that govern various licenses.

Business Disputes

We frequently represent health care providers in health care business disputes and business litigation. Using our knowledge and understanding of health care compliance and regulatory issues, our team of experienced litigation attorneys has represented individual providers, medical groups, facilities, and other entities in a broad range of civil disputes.

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