C. Mitchell Goldman is a business adviser and healthcare entrepreneur who focuses his practice on the finance and corporate aspects of healthcare delivery, with an emphasis on reimbursement, risk contracting, structuring corporate transactions between and among providers and advising clients on the impact of federal and state government regulation. He has also advised healthcare entrepreneurs in improving their business strategies and identifying sources of angel, private equity and venture capital financing.
During the healthcare reform debate, he advised the staffs of a number senators on the impact of key aspects of the healthcare reform legislation, including the need for primary care physicians and private sector alternatives to health insurance. He was the subject of a profile by the Philadelphia Inquirer as a thought leader on healthcare reform and published an article for Modern Healthcare on the importance of innovation in healthcare reform.
Mr. Goldman has handled many healthcare-related transactions, including the purchase and sale of ambulatory surgery centers, mergers of hospitals and physician practice mergers and acquisitions. He currently advises his hospital and physician clients on the opportunities associated with healthcare reform, including accountable care organizations ("ACOs"), patient centered medical homes and Medicare reimbursement demonstration projects. Recently, he has been a leader in the Mobile Health/HealthCare IT Practice Group and has advised a number of mobile health ventures in their early stages of development. Recently, he has spoken at a national conference on the investment opportunities in mobile/digital healthcare.
Mr. Goldman has advised a number of very successful physician entrepreneurs. Under Mr. Goldman's leadership, they have formed an ad hoc group known as the Physician Entrepreneurs' Roundtable, which acts as a networking and angel investing group focused on healthcare start-ups. Over the past several years, the group has raised between 1.5 to 5.5 million dollars per year for new healthcare start-ups.
Upon joining Duane Morris as a partner in the Health Law Practice Group, he developed an innovative approach to medical malpractice insurance and lead the development of four medical malpractice companies offering coverage to physicians in Florida, Pennsylvania, Maryland and New Jersey. The Pennsylvania company is now the third-largest writer of medical malpractice insurance for physicians in Pennsylvania.
Mr. Goldman is a frequent lecturer and writer on healthcare reform, healthcare reimbursement and new business opportunities for hospitals and physicians. He is an adjunct professor of law at the Earle Mack School of Law at Drexel University, where he teaches Health Care Finance. He is a member of the American Health Lawyers Association, and a founder and Board Chairman of CADEkids, a Philadelphia nonprofit organization working with high-risk children in lower and middle schools to reduce violence, bullying and to improve self-esteem. Mr. Goldman is a 1980 graduate of Temple University School of Law, a graduate of the University of Pennsylvania, Wharton Graduate Health Care Administration Program, where he received his M.B.A., and a graduate of Bowdoin College.
He is the founder of GLS Associates, Inc., a management consulting firm that served healthcare providers for 20 years, and a staff member in the office of former Senator Walter F. Mondale.
- Concierge Medicine: Represents a premier concierge medicine company advising the client on the corporate practice of medicine, marketing, privacy and other critical issues associated with the concierge medicine business.
- Client Text Messaging Mobile Health Application: Advised founders in revising the business plan, identifying potential investments, finding strategic partners/customers and ongoing legal advice.
- Wage Index Geographic Reclassification: Advising a new hospital system on how to obtain a higher wage index to effectively compete with other hospitals in the marketplace.
- Tricare Hospital Group Settlement: Led the strategy to obtain a substantial recoupment of certain TRICARE underpayments for more than 300 hospitals over a period of more than 9 years.
- Consumer Operated and Operated Plans (CO-OP): Was the health care reform expert for a large University teaching hospital, to prepare an application for funding of a CO-OP as provided under the Affordable Care Act.
- Hospital General Counsel: Have served as counsel to a 300 bed community hospital, reporting to the CEO and the board. Handling all issues associated medical staff governance and credentialing, hospital physician joint ventures; negotiating the purchase of medical malpractice insurance and captive alternatives for hospital and independent medical staff, regulatory counseling on HIPAA, Medicare and Medicaid fraud and abuse concerns and Certificate of Need laws. Negotiated the purchase of primary care physician practices, chief advisor on redesigning hospital business relationships with certain physician groups. Advised hospital and board on antitrust strategy concerning new ventures.
- Hospital Sale: Representing a 350-bed nonprofit hospital in the sale to a for-profit system and the creation of a community foundation with assets in excess of $50 million.
- Leading Edge Medical Malpractice Insurance Company: Founder of a medical malpractice insurance company, an affiliate of Duane Morris, now licensed in three states with more than 1500 physician insureds. This is a new model of insurance that brings the hospitals, the physicians and the insurers together to reduce the number and the cost of claims as well as to improve patient safety.
- Reimbursement Negotiations: For a large multi-hospital emergency medicine group, challenged the payment practices of a major insurer where the client has lost more than three million dollars. Through an innovative legal interpretation of the insurers payment practices and the filing of a lawsuit, we obtained a settlement valued at more than 2.5 million dollars in cash and increased reimbursement.
- Ambulatory Surgery: Represented the three physician owners in the development of an ambulatory surgery center. Obtained all the approvals, structured the business transaction and remained as reimbursement and regulatory counsel for the center for the past 15 years. The center is a six room facility which has recently been valued at more than 20 million dollars.
- Anesthesia Purchasing Group: Structured a 300 person anesthesia buying group and represented the group as general counsel. We developed an innovative malpractice insurance product which involved some risk sharing and in the end has resulted in significant savings over a four year period.
- HIPAA Hospital Personnel Training: For a major state hospital association, designed the training materials and conducted more than 15 live and/or teleconferences for more than 1000 hospital employees. The training modules included general training on the key aspects of HIPAA compliance and detailed modules on business associate agreements, minimum disclosure rule, HIPAA preemption and special training programs for physicians.
- Special Counsel to the Bankruptcy Court: Appointed by the Court as an expert to evaluate Medicare claims for a bankrupt healthcare provider. Designed a sampling procedure and negotiated a settlement with the Medicare program and the U.S. Attorney's office to collect more than 4 million dollars for the unsecured creditors.
- Medicare Receivables Financing: For a major Catholic healthcare provider, developed a solution to financing the accounts receivable of one of its hospitals that was closing its doors. The client's general counsel had indicated that this transaction could not be done under the Medicare law. The final solution to the client's problem resulted in receiving approximately 3 million dollars by selling their receivables under our recommended process.
- U.S. District Court for the Eastern District of Pennsylvania
- Supreme Court of Pennsylvania
- Temple University School of Law, J.D., 1980
- Duane Morris LLP
- Partner, 1999-present
- Founder, General Counsel, American Healthcare Providers Insurance Exchange, 2003-2007
- Managed Care Strategies, Inc., Philadelphia, Pennsylvania
- Vice President, 1988-present
- GLS Associates, Inc., Philadelphia, Pennsylvania
- Vice President and Shareholder, 1975-1995
- Goldman & Marshall, P.C., Philadelphia, Pennsylvania
- President, 1981-1999
- A frequent author and lecturer on matters involving legal and insurance issues in managed care contracting and with the American Hospital Association Managed Care Forum, The Institute for Behavioral Health, the Hospital Association of Pennsylvania, and the Healthcare Financial Management Association. He has also lectured on insurance fraud and abuse for the American Hospital Association's Society for Strategic Planning and Hospital Marketing.
- Adjunct Professor, Health Care Finance, Drexel University, Earle Mack School of Law
- Founder and Corporate Secretary, Corporate Alliance For Drug Education, 1986-present; President, 2002-2006
- Outside Director, Chairman of Audit Committee, Penn Treaty American Corporation, 1987-1999
- American Bar Association
- Legislative Audit Committee, Pennsylvania Legislature, 1990-1992
- Philadelphia Bar Association
- American Health Lawyers Association
- American Hospital Association
Honors and Awards
- Listed as a Top Rated Lawyer in Healthcare by American Lawyer Media and Martindale-Hubbell™, 2013
- AV® Preeminent™ Peer Review Rated by Martindale-Hubbell
- Co-author, "mHealth Revenue Models: Finding the Right One for the Right App," mHealth Newsletter, June 26, 2013; republished by Law360, July 17, 2013
- Quoted in "Healthcare IT: The Next Big Thing in Philadelphia Business?" imPACT Times, December 2012
- "Healthcare Reform and New mHealth Business Opportunities: What mHealth Entrepreneurs Should Know After the Presidential Election," mHealth Newsletter, November 14, 2012
- Interviewed, "The Wharton Healthcare Quarterly Interviews Mitch Goldman, Equity Partner of Duane Morris, LLP," The Wharton Healthcare Quarterly , July 19, 2012
- Co-author, "mHealth Stakeholders: Bullet List of Legal Considerations," mHealth Newsletter, May 21, 2012; republished by Law360, June 4, 2012
- Co-author, "HHS Releases Final Rule and Interim Final Rules on Affordable Care Act's State Health Insurance Exchanges," Duane Morris Alert, March 14, 2012
- Co-author, "Reform Means Hospitals Must Consider Primary Care Strategies," Modern Healthcare, July 2011
- "IRS Publishes Guidance on Healthcare Reform Changes to Form W-2," Duane Morris Alert, April 1, 2011
- Quoted in "Health Care Reform Lawsuits Likely Headed to Supreme Court" by Melissa Maleske, Inside Counsel, February 1, 2011
- Co-author, "HHS Announces $335 Million in Available Funding for Existing Healthcare Centers ," Duane Morris Alert, November 19, 2010
- "Navigating Healthcare Reform," American Law Institute, American Bar Association (ALI ABA), October 2010
- Co-author, "Healthcare Reform—Some Key Business Opportunities Every Hospital CEO Should Know," Modern Healthcare, April 2010
- Quoted in "Law Review: A Prescription on Healthcare Reform," The Philadelphia Inquirer, January 26, 2010
- Co-author, "Increase Number of Insurance Providers," Modern Healthcare, December 8, 2009
- "A Public Option Compromise For Insurance Competition," Law 360, September 30, 2009
- Co-author, "Adopting Electronic Medical Records: What Do the New Federal Incentives Mean to Your Individual Physician Practice?, The Journal of Medical Practice Management, July/August 2009
- Co-author, "A Series of Unfortunate Events: Is This the End of the Physician/Hospital Joint Venture?" Health Lawyer News, February 2009
- Co-author, "The Recession is Real: Ten Steps a Hospital CEO Should Consider Taking Now," Modern Healthcare, April 2008
- Co-author, "The Malpractice Insurance and Quality Conundrum," published sixth in a series of Managed Healthcare Insights, based on the Wharton Health Care Management Alumni Association conference, Philadelphia, Pennsylvania, October 2002
- "Why Physician Groups Are Self-Insuring," published by Journal of Medical Practice Management, July/August 2006
- "Doctors Revive Risk Retention Groups," published by New Jersey Law Journal, July 17, 2007
Selected Speaking Engagements
- Co-Presenter, "Mobile Health and What It Means To You," Webinar for The Compliancy Group, LLC, September 17, 2013
- Panelist, "The 2013 mHealth Prognosis: Converging Business and Legal Trends," Bodek Lounge, University of Pennsylvania, June 26, 2013
- Speaker, "Implications of Health Care Reform," Creative Benefits, Inc., Newtown Square, PA, May 7, 2013
- Speaker, "Federally Qualified Health Plans, CO-OPs, and Health Insurance Exchanges," Executive Leadership Series Health Summit, Clearwater Beach, Fla., March 20, 2013
- Speaker, "Implementing Health Care Reform – Implication for Health Care IT," Information Systems Audit and Control Association, Villanova, Pa., March 14, 2013
- Speaker, "Health Care Reform Update; Elections Have Consequences – What's Next?" Pennsylvania Institute of Certified Public Accountants, Penn State Great Valley, Malvern, Pa., November 15, 2012
- Speaker, Health Care Reform, Scranton, PA, September 13, 2012
- Co-Speaker, "Building for the Future: The Market Environment," mHealth Summit, National Harbor, Maryland, December 4, 2012
- Speaker, "ACOs and PHOs: What Are the Options?" Good Samaritan Physician Hospital Organization, Lebanon, Pa., April 12, 2012
- Co-Speaker, "Payer Accountability Forum Teleconference," Teleconference, February 15, 2012
- Speaker, "Legislative Update 2011," Pennsylvania Institute of Certified Public Accountants, Harrisburg, Pa., November 16, 2011
- Speaker, "Legislative Update: Health Care Reform," Pennsylvania Institute of Certified Public Accountants, Harrisburg, Pa., June 8, 2011
- Speaker, "Accountable Care Organizations: Legal & Operational Implications for Pennsylvania Hospitals," Hospital & Healthsystem Association of Pennsylvania seminar, Fort Washington, Pennsylvania, May 6, 2011; Warrendale, Pennsylvania, May 19, 2011
- Speaker, "Healthcare Market Update and Application to M&A Strategy," ACG InterGrowth Annual Meeting, San Diego, March 21-23, 2011
- Speaker, "Key Issues Facing Boards of Directors: Prospering in a Post Health Reform World, the Revolution in Healthcare and Other Benefits," Directors Roundtable Program, Philadelphia, June 29, 2010
- Speaker, "Healthcare Reform: What Is the Impact on Employers?" Duane Morris Institute Webinar, April 28, 2010
- Speaker, "Spotlight: The Impact of Health Care Reform on the Pharmaceutical Industry," ACI's 10th National Forum on Fraud and Abuse in the Marketing of Drugs, New York City, March 25, 2010
- Speaker, "Healthcare Reform: Impact on Employers," HR Symposium, Philadelphia, June 10, 2009
- Speaker, "Physician/Hospital Joint Ventures: What Next for Physician Entrepreneurs," American Bar Association Health Law Section 10th Annual Conference on Emerging Issues in Health Law, February 19, 2009
- Speaker, "Hospital Syndications: Opportunities and Options, or a Thing of the Past," ABA Health Law Section 9th Annual Conference on Emerging Issues in Healthcare Law 2008, San Diego, California, February 21, 2008
- Speaker, "New Approaches to Professional Liability Insurance for Better Physician and Hospital Experience," American Health Lawyers Association, Hospitals and Health System Law Institute, Orlando, Florida, February 15, 2008
- Speaker, "Hospital Syndications: The Opportunities and Pitfalls," ABA Health Law Section 8th Annual Conference on Emerging Issues in Healthcare Law 2007, Orlando, Florida, February 21-23, 2007
- Co-presenter, "New Insurance Options for Managing Hospital and Physician Risk," New Jersey Hospital Association, January 26, 2006