The combination of an aging population, ongoing medical advancements and health care reform brings even more complexity to the already intricate arena of health care law. Foster Swift's team of experienced health law attorneys has been serving the industry long before its current rise in the public eye.
Complementing the experience of our Health Care Practice Group is the unique blend of regulatory, transactional and litigation attorneys all of whom are knowledgeable with the myriad of health care issues. We represent:
- Physician groups
- Home health and hospice providers
- Long-term care and assisted living providers
- Health care systems and networks
- Managed care organizations
- PACE organizations
- Physical therapy providers
- Pharmacies and durable medical equipment companies
- Integrated delivery systems
- Health information technology companies
- E-health businesses
- Health-care-related supplier trade associations
- Non-profit health care foundations and organizations
- Waiver Organizations
With Foster Swift, clients have the benefit of counsel who have a thorough understanding of the clinical and business realities of health care as well as the legal and regulatory requirements.
Clients have retained us for assistance in:
Regulatory and Reimbursement
Clients seek our assistance on a variety of regulatory and reimbursement matters before local, state, and regulatory agencies, including:
- Licensure and certification matters
- Provider-based status matters
- Medicare and Medicaid appeals
- Health care insurance provider audits
- Certificate of Need matters
- Third party reimbursement matters, including Blue Cross Blue Shield of Michigan audits
- Anti-Kickback and Stark II matters
- False claims investigations and litigation
- Tax exemption and TBOR II matters
In this fast-paced health care environment, our attorneys assist clients with the formation, development and management of affiliations, acquisitions, mergers, joint ventures and newly integrated organizations. This includes clinically integrated networks and accountable care organizations. Our role can be as simple as reviewing documents or as complex as heading up a multi-member transactional team.
Fraud and Abuse Matters
Members of the Foster Swift Health Care Group regularly assist clients in structuring transactions to minimize Anti-Kickback, Stark II, and False Claims. Assisting our clients with the development and implementation of effective compliance programs is key to our practice. We also help our clients with self-referral disclosures to centers for Medicare and Medicaid services.
Managed Care, Insurance and Employee Benefits
With multiple attorneys with decades of experience, health maintenance organizations, insurance companies, self-funded plans and third party administrators seek us out for representation before the Michigan Office of Financial and Insurance Service. In addition we regularly provide advice to networks of hospitals and physician providers on contractual matters, regulatory filings, appeals, credentialing and all aspects of litigation that may arise.
Licensing and Credentialing
The first step in the career of any health professional is obtaining the state and federal licenses needed to engage in practice. The next is successfully receiving credentials from hospitals, provider organizations, health plans, private and governmental payors, and other entities. Once embarked on their careers, health professionals face the dreaded risk of a licensing investigation by state or federal authorities or a peer review and privileging action by a hospital or other credentialing organization. The number of licensing and disciplinary actions has increased greatly in recent years, and even good health professionals can become embroiled in these stressful and career-threatening matters.
Our attorneys routinely and successfully advise health professionals in:
- Obtaining licensing, staff privileges, and credentialing, especially when there are issues that could delay or interfere with application and approval
- Challenging denials of licenses, privileges, and credentialing
- Responding to investigation requests from professional licensing agencies
- Defending against licensing complaints
- Assisting in responding to peer review requests from hospitals and other facilities
- Handling medical staff and credentialing disputes and fair hearing proceedings
- Reporting requirements imposed by licensing agencies, hospitals, provider organizations, and health plans
- Contesting and correcting adverse action reports to the National Practitioner Data Bank
- Pursuing and defending against lawsuits related to these matters
Minimizing client risk is always our goal as we assist vendors and purchasers in addressing the legal considerations surrounding the acquisition and implementation of information technology systems in the health care industry. Our expertise includes:
- Formation, financing and governance of business entities
- Development, marketing and distribution arrangements
- Drafting licensing agreements, systems implementation agreements, joint development agreements and outsourcing agreements
- Advising on Internet and new technology issues
- Product liability
- Information Technology clients also rely on our attorneys to negotiate and draft employment and non-compete agreements.
As general counsel to more than 100 health care industry-related clients, many have spanned decades, we become involved in matters unique to individual clients needs and operating goals of the organization, such as:
- Risk management issues
- Employment, labor and benefits issues
- Matters involving the privatization of health care facilities
- Agreements and joint ventures with physicians
- Medical records
- Compliance issues
- Utilization review
- Provider policies
- Hospital finance and bond issuances
HIPAA Privacy and Security Rules AND HITECH ACT
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy and Security Rules are a concern of every health care provider, and our attorneys are committed to helping clients avert risk through the implementation of compliance programs as well as on-going training for all staff. In accomplishing this, we have extensive experience in helping health care providers transition their practices to electronic medical records and the Internet. We also advise clients on the day-to-day issues arising from the HIPAA Privacy and Security Rules, as well as represent clients in Electronic Health Records (EHR) incentive program audit and appeals.
Foster Swift attorneys are top-tier litigators with an impressive track record of handling complex litigation on behalf of health care clients, including cases involving reimbursement, contract disputes, employment and medical staff issues, fraud and abuse, antitrust, licensing and many more.
Over the years, Foster Swift attorneys have been involved in many important cases before state and federal appellate courts. This includes authoring numerous amicus briefs which have been referenced in many key state and federal appellate court opinions.
RECOGNITION FOR OUR ATTORNEYS
Well respected by their peers, more than half the members of this practice area are included in the Health care category of Best Lawyers in America and have AV® Preeminent rating from Martindale Hubbell. Based on the breadth of their skill, Foster Swift Health Care attorneys have been asked for over two decades to provide the “Michigan Health Law Update” at the annual meeting of the Institute of Continuing Legal Education Health Law Institute.
Foster Swift Health Care attorneys are committed to providing excellent legal counsel in an efficient and economical manner to help clients keep pace with the ongoing change.
Foster Swift has been named a Tier 1 firm in Health Care Law in Lansing and Detroit by U.S. News – Best Lawyers® "Best Law Firms" in 2014, 2016, 2017, 2018 and 2019.
Recent Blog Posts
- Cybersecurity Concerns in Health Care
- HHS Office for Civil Rights Publishes Checklist for HIPAA Covered Entities Responding to Cybersecurity Incidents
- The Importance of IT Contract Review
- Health Care Law Blog: Mobile Medical Apps
- Supreme Court Holds that a Patent of the Process of Administering a Drug is Invalid
- Make Sure you Know Who's Talking about Your Company!
- Into the Breach . . .
- Deadline for EHR Attestation Fast Approaching
- EHR Incentive Program Updates
- CMS Recognizes Additional Hardship Categories for Electronic Prescribing Waivers
Publications & Alerts
- New Disability Claims Procedures Take Effect on April 1st, March 2018 Business & Corporate Law News, March 12, 2018
- U.S. Supreme Court Affirms that Collective Bargaining Agreements Must be Interpreted According to “Ordinary Principles of Contract Law”, March 2018 Business & Corporate Law News, March 12, 2018
- How do the OFAC Regulations Apply to Health Insurance Policies?, Foster Swift Healthcare Law E-Blast, August 2, 2017
- Legalease: Choosing Correct Power of Attorney for a "Control Freak", West Michigan Plus, March 28, 2016
- Significant Stark Law Changes in 2016 Medicare Physician Fee Schedule Intended to Ease Compliance Burden, Foster Swift Health Care Law News, January 4, 2016
- Protecting the Hospital Tax Exemption Part IV: Billing and Collection Requirements, Foster Swift Health Care Law News, April 23, 2015
- Emerging Trend: A Defined Contribution Approach to Health Care Coverage, Lansing Economic Club, October 27, 2016
- ESOP Administration Q+A- Get Your Questions Answered, Great Lakes Regional ESOP Conference, October 20, 2016
- ERISA Fiduciary Duties and Retirement Plan, July 21, 2016
- Legal Issues for the Medical Professional, Health Care Financial Management Association's Western Michigan Chapter, September 16, 2015
- Legal Consideration for the Treatment of Minors, Kent County Dental Society, March 11, 2015
- The Problems and Solutions Involving Healthcare, Michigan State International Law Review, February 20, 2015
- What Family Law Attorneys Need to Know about Health Care Reform, Grand Rapids Bar Association Family Law Section, October 22, 2014
- 42 Foster Swift Attorneys Listed as Best Lawyers® 2020, August 15, 2019
- Kraus Reelected to ABA Council of Appellate Lawyers Executive Committee, November 19, 2018
- Foster Swift Rated Tier 1 in 27 Practice Areas in Best Lawyers® "Best Law Firms", November 1, 2018
- 45 Foster Swift Attorneys Listed in Best Lawyers in America© 2019, August 15, 2018
- Six Foster Swift Attorneys Named Best Lawyers® 2019 "Lawyer of the Year", August 15, 2018
- Johnson Selected to “Women in the Law” Class of 2018, Grand Rapids Business Journal, August 2, 2018
- Firm Elects Health Care Practice Group Leader, Grand Rapids Business Journal, March 7, 2018
Richard Kraus and Gary McRay have consistently been selected by their peers for inclusion in The Best Lawyers in America® for Health Care Law, and Jennifer Van Regenmorter was recently added to the 2018 roster. Richard Kraus was also named the Best Lawyers® 2017 Health Care Law "Lawyer of the Year" in Lansing.