Health Care

Shipman & Goodwin has a comprehensive health law practice providing legal services to all sectors of the health care industry. We have a broad depth of experience advising our health care clients on all the issues that impact their operational and business objectives. 

Representative Clients Include:

Hospitals and Integrated Delivery Systems. Acute, general and specialty hospitals, including long-term acute care, psychiatric and hospitals with Level One trauma centers designation. We regularly advise our hospital and health system clients in connection with system development, strategic alliances, corporate governance and regulatory issues.

Community Providers. We represent a large number of community-based organizations that provide primary care, behavioral health and substance abuse services to children and adults with special needs and disabilities. 

Federally Qualified Health Centers.  We provide Federally Qualified Health Centers ("FQHCs") with a full range of Section 330-specific counseling services for the development, evaluation, implementation, grants, orientation and support of effective programs.  We also provide legal assistance with issues pertaining to FQHC benefits, including cost-based reimbursement, 340B program, Federal Tort Claims Act, and the National Health Service Corps.

Ambulatory Surgery Centers.   We regularly advise hospital-based and freestanding ambulatory surgery center in connection with certificate of need issues, joint ventures, regulatory compliance and matters relating to reimbursement. 

Physicians and Health Care Professionals. We have significant experience in representing and advising physicians and other health care professionals with respect to practice management, joint ventures, alternative care delivery models, including independent practice associations, physician hospital organizations, medical foundations, medical homes and accountable care organizations.

Long Term Care, Home Health and Hospice. We represent skilled nursing facilities, long term care providers, home health, hospice, assisted living services agencies, and continuing care retirement communities on all business and regulatory matters.

Clinical Laboratories. We represent local and national clinical laboratories, including laboratories specializing in clinical, genetic, infectious disease and microbiology testing. We have expertise in the business and regulatory issues facing laboratories.

Retail Pharmacies. We represent local and national pharmacies in business and regulatory matters, including issues involving licensure, reimbursement and electronic prescribing.

Professional Certifying Boards. We advise physician-specialty boards on professional credentialing, certification, testing, joint ventures, intellectual property and corporate governance issues.

Organ Procurement and Transplant.  We represent procurement organizations and transplant hospital programs on all regulatory and business matters.

Our Health Law Practice Group has substantial experience regularly advising our health care clients in the following subject matter areas: 

Mergers, Acquisitions, Strategic Alliances and Business Transactions. We advise our health care clients on all transactional matters, including mergers, acquisitions, strategic alliances, joint ventures, management, co-management and other business combinations. We can get the transaction done, obtain the necessary regulatory approvals, negotiate, document and implement the transaction in accordance with all regulatory requirements.

Health Information and Privacy. We regularly advise our clients on managing protected health information under state and federal laws, including structuring health information exchanges, implementing electronic health record systems and subsidy programs, and complying with privacy and security requirements, including breach response and state and federal enforcement actions.

Corporate Compliance and Regulatory Issues. We regularly advise our health care clients on state and federal regulatory matters and compliance issues, including designing, implementing and managing corporate compliance programs, responding and handling government payor investigations and audits, analyzing fraud and abuse, Stark, Anti-kickback and negotiating with government enforcement agencies.

Reimbursement, Audits and Investigations. We advise all providers on Medicare and Medicaid reimbursement related to business planning and compliance.  We also represent them on OIG, RAC and other governmental payor audits, investigations and appeals.

Medical Staff. We advise hospitals and physicians on credentialing, privileging, peer review, professional misconduct, disciplinary action, compliance, bylaws and governance issues.

Certificate of Need. We regularly represent applicants and intervenors in certificate of need matters related to change of ownership, corporate affiliation, joint ventures, technology acquisitions and introduction and termination of services.

Clinical Research. We advise health care providers and bioscience companies on clinical and translational research issues involving conflicts of interest, research misconduct, institutional review boards (IRBs), informed consent, privacy and data issues, and sponsor and investigator agreements.

Health Care Reform. In response to the Health Care Reform Act, we have created a Health Care Reform Resource Center to keep our clients apprised of developments and shepherd providers through the regulatory developments as they prepare for new opportunities.  We advise our clients on building the necessary infrastructure and developing the sytems and strategic alliances to organize medical homes, accountable care organizations and other innovative delivery of care models.

Publications

January 11, 2012  CMS Publishes Guidance on Medicaid RAC Program
November 22, 2011  DSS Releases Proposed Medical Foundation Regulations
November 17, 2011  OCR Begins Pilot Phase of HIPAA Privacy and Security Audit Program
November 10, 2011  New DRS Special Notice Regarding Hospital Net Patient Revenue Tax
November 7, 2011  Adding To The Value Of Health Care Construction
November 3, 2011  FINAL RULE: Medicare Program--Changes to the Ambulatory Surgical Centers Patient Rights Conditions for Coverage
September 28, 2011  Are You Aware of and Affected by These DPH Scope of Practice Requests?
August 16, 2011  Health Law 2011 Legislative Update
August 8, 2011  Sample Workplace Violence Prevention Policy to Comply With New Connecticut Legislation
August 4, 2011  CMS Proposes to Extend the 3-Day DRG Window to Hospital-Owned and Hospital-Operated Physician Practices
July 11, 2011  OCR Proposes Significant Revisions to HIPAA Rules on Accounting of Disclosures
June 10, 2011  CMS Clarifies that State Medicaid Agencies Have Ability to Protect Same-Sex Couples
June 3, 2011  CMS Issues Final Rule on Denial of Medicaid Payments for "Hospital Acquired Conditions"
June 3, 2011  CMS Announces Proposed Changes to eRX Incentive Program
May 16, 2011  Be Wary Of Medical Companies Bearing Gifts
May 5, 2011  CMS Releases Final Rule on Telemedicine Credentialing and Privileging
April 1, 2011  Proposed Rules Regarding Accountable Care Organizations Issued
February 28, 2011  First-Ever Civil Monetary Penalties Imposed for Violation of the HIPAA Privacy Rule
January 14, 2011  Summary of Proposed Certificate of Need Regulations
December 28, 2010  Sample Hospital Patient Visitation Policy To Comply With New CMS Rules For Participation
November 15, 2010  Recent Settlement Demonstrates Pitfalls of Rewarding Physicians with Access to Hospital Facilities
September 21, 2010  The Medicare and Medicaid EHR Incentive Programs: What You Need to Know.
August 13, 2010  June 2010 Connecticut Health Law Legislative Update
August 10, 2010  HHS Announces Proposed HIPAA Rules
December 8, 2009  Recent Modifications to HIPAA's Breach Notification and Enforcement Rules
October 28, 2009  Recent Law Modifies Connecticut HIV Testing Consent Requirements
August 14, 2009  Recent Law Establishes Medical Foundation Option for Hospitals and Health Systems
June 17, 2009  Recent Law Modifies Office of Health Care Access Certificate of Need Statutes
May 1, 2009  CMS Issues Guidance on EMTALA Regulations
March 2, 2009  Stimulus Package Significantly Expands HIPAA Requirements
November 6, 2008  Stark Health Care Alert
July 18, 2008  New Connecticut Law Mandates Safeguards for Personal Information and Social Security Numbers
July 15, 2008  HIPAA Security Alert - Executive Guidance
March 2008  Medicare Contracting Reform
March 2008  Health Care Alert
February 20, 2008  401(k) Plans - Supreme Court Decision
July 23, 2007  2007 Connecticut Healthcare Legislation
June 22, 2007  Supreme Court Rules “Companions” Are Not Entitled To Overtime And Minimum Wage In Connecticut, New York, And Vermont
January 2, 2007  CMS Issues Final Patients’ Rights Rule Regarding Use of Restraints and Seclusion in Hospitals
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