Duane Morris lawyers are experienced advocates and counselors who partner with our post-acute care and senior services provider and supplier clients to help them meet their business needs and goals. Duane Morris’ experience in this healthcare sector is based on a well-developed understanding of the industry and the governmental agencies that regulate it. The firm’s approach to representing providers and suppliers involves a coordinated effort among lawyers with experience in relevant subject matters, including health law, corporate law, tax-exempt law, employment law, information technology law, real estate law and litigation.
Our lawyers have prior experience in government, industry, in-house counsel positions and healthcare delivery. This experience shapes how we represent our clients. Duane Morris lawyers understand the day-to-day operations of post-acute care and senior services providers and suppliers and the legal challenges and opportunities that affect them. We have built and continue to foster deep relationships with industry leaders and stakeholders that inform our ability to effectively represent and partner with our clients. Attorneys in the group are active in state and national trade association activities, serving on the legal committees of the American Health Care Association and its state affiliates and on the executive board of the American Seniors Housing Association.
Duane Morris attorneys represent operators, investors, developers and capital providers in virtually all industry segments, including skilled nursing and rehabilitation facilities; continuing care retirement communities (CCRCs); assisted living and seniors housing communities; home care agencies; hospices; adult day healthcare providers; gerontological, rehabilitation and other professional services providers; in-home and portable radiological services companies; durable medical equipment suppliers; ancillary services and supply providers; and long-term care pharmacies. Our clients range from the smallest single-facility providers to some of the largest providers of post-acute care, assisted living and other senior services in the United States. We also represent parties investing in the industry.
Our practice covers transactional, regulatory and litigation matters. We have a broad range of experience and knowledge in the industry, including the following areas of concentration:
- Acquisitions and Sales
- Capital Formation, Debt and Equity Financing
- Regulatory Compliance, Risk Management, and Fraud and Abuse Counseling
- Government Audits, Investigations and Enforcement Matters
- Administrative Hearings and Litigation
- Medicare, Medicaid, Managed Care and Private Reimbursement Matters
- Certificate of Need, Licensing and Change of Ownership
- Consumer Privacy and HIPAA
- General Advice and Counsel
Acquisitions and Sales
We have extensive experience in the acquisition and sale of nursing homes, assisted living residences, institutional and outpatient providers, home- and community-based providers and other healthcare businesses in this sector. After defining our clients’ desired objectives, we work with them to obtain the maximum long-term benefit from the transaction. Duane Morris attorneys represent both buyers and sellers and coordinate closely with federal and state regulators on licensure matters related to the transaction. We are often involved in helping our clients identify sources for financing, and we also represent lenders in financing acquisitions.
Capital Formation, Debt and Equity Financing
Duane Morris attorneys have an extensive understanding of the transactional, regulatory and business climate for entrepreneurs and private equity funds; accordingly, we are well-positioned to help formulate strategies, deal structures and terms designed to ensure optimal solutions. Our lawyers understand that each potential investment is a unique decision with important implications for the investor.
Regulatory Compliance, Risk Management, and Fraud and Abuse Counseling
Duane Morris attorneys assist clients in a broad range of regulatory matters. To aid effective corporate oversight, we counsel our clients on risk management and establishment of sound healthcare regulatory corporate compliance programs. We also draft or review agreements with vendors, suppliers and independent contractors, focusing on the specialized issues and rules affecting healthcare providers. When needed, Duane Morris coordinates and conducts internal investigations, with an eye toward risk minimization and attorney-client privilege considerations. The firm’s lawyers are well-versed in the changing self-reporting requirements and provide reasoned advice on approaching and disclosing potential problem areas to regulatory authorities.
In addition, we routinely advise post-acute care and assisted living providers on matters relating to compliance with the myriad regulatory requirements affecting their day-to-day operations, whether they involve HIPAA, the Deficit Reduction Act, the Affordable Care Act, the federal Anti-kickback Statute, the False Claims Act or comparable state laws that present risk for civil or criminal liability. Our objective in counseling our clients is to find practical, common-sense ways to meet compliance obligations, from to general issues to healthcare fraud and abuse concerns.
Government Audits, Investigations and Enforcement Matters
Duane Morris lawyers have extensive experience in representing healthcare clients in audits or investigations by government agencies. Our representations include encounters with state Offices of the Medicaid Inspector General and Medicaid Fraud Control Units and other divisions of state attorneys general offices, the U.S. Department of Health and Human Services Office of Inspector General and the U.S. Department of Justice. We also support our clients in resolving qui tam or whistleblower matters, as well as alleged fraud and abuse issues.
We have negotiated settlements of government investigations that minimize the financial impact on our clients, and we have negotiated corporate integrity agreements and counseled clients on fulfilling obligations under them. We also have handled Medicaid and Medicare audits, including carrier and fiscal intermediary matters, analyzing whether the situation warrants repayment of funds.
Administrative Hearings and Litigation
Duane Morris attorneys are adept at advising clients on issues that may result from federal and state regulatory actions of various sorts, including adverse findings of quality of care relating to both Medicare and Medicaid Conditions of Participation, reimbursement and overpayment matters, certificate of need, involuntary transfer and discharge proceedings, and allegations of abuse or neglect. We are experienced in informal dispute resolution methods, as well as evidentiary hearings before federal and state agencies.
Our broad regulatory experience assists our clients in determining the most advantageous path to avoid litigation. Should litigation result, we have the in-house depth to respond.
Medicare, Medicaid, Managed Care and Private Reimbursement Matters
We have substantial experience with the federal Medicare administration agency and the Centers for Medicare and Medicaid Services, and our attorneys have direct experience with Medicaid reimbursement matters in some of the largest states. With constant downward pressure on reimbursement, facilities need skilled advocates who can successfully challenge adverse decisions. Our comprehensive experience is also well-matched with our national coverage. As Duane Morris has a significant national healthcare practice, we often call on attorneys from our various offices to work through local issues for regional or national clients.
Certificate of Need, Licensing and Change of Ownership
We are accomplished in guiding clients through certificate of need or change of ownership processes and can ably address regulators’ concerns. Duane Morris attorneys assist clients through the complete application process, including developing information to satisfy the agency’s review factors (need, character and competence, and financial stability) and negotiating difficult issues with regulatory authorities. Our goal is to obtain the requisite approval for our clients in the shortest time possible. Among our attorneys are former state officials who know what state regulators require and, just as significant, how regulators prefer to work through these applications.
Consumer Privacy and HIPAA
Post-acute care providers must ensure the privacy and security of residents’ health information under HIPAA and state law. The cybersecurity of health information is an increasing concern as long-term and post-acute care providers exchange information with hospitals and other providers, and as residents and providers use mobile and other health technology platforms. The firm’s healthcare group has extensive experience assisting clients in complying with the laws and best practices governing the privacy and security of health information to reduce the risk of a violation or security incident, as well as promptly responding to incidents, including breaches.
General Advice and Counsel
Duane Morris attorneys draw upon their knowledge and experience to provide a range of advice and counsel to our healthcare clients. We serve as counsel to individual providers and trade associations alike. This gives us the insight to develop creative solutions to problems faced by our clients. Many of our healthcare lawyers have direct experience working in the healthcare industry, giving us a firsthand perspective on what is needed to succeed and how best to accomplish transactions, navigate regulatory frameworks and manage litigation-related situations.
For Additional Information
For more information, please contact Susan V. Kayser or any of the practice members referenced in the Attorney Listing.