Overview

As the health care industry continues to experience dramatic change, we continue to provide cutting-edge representation in today’s highly regulated and ever-shifting competitive environment. Hinckley Allen is one of the most respected and experienced healthcare practices in the Northeast. Our healthcare attorneys use their industry knowledge, experience and legal skills to provide sophisticated and strategic guidance on the most difficult issues facing healthcare providers, including evolving models for delivery of care and reimbursement, the need for various strategic alliances, insurance, technological advances, regulatory compliance, risk management, government enforcement and white collar defense, and complex disputes and investigations.

Effective counsel wherever law and healthcare intersect.

Our clients cover the spectrum of healthcare providers and facilities. We work with teaching, tertiary and acute care hospitals, nursing facilities, continuing care retirement communities, and other senior housing and care organizations, as well as hospital systems, physician-hospital organizations, and clinically-integrated networks. We represent community-based providers, including: home health agencies, visiting nurse associations, hospices, clinics, ambulatory surgery centers, provider networks (including faculty practice plans), clinical laboratories, mental health centers, and physician groups. We advise trade associations serving hospitals, nursing facilities, and other healthcare entities on both general and specialized regulatory matters.

Services

The broad array of services we offer to our healthcare clients on both routine and urgent matters, include:

Business Transactions

  • Accountable Care Organizations (ACOs) and other clinically-integrated networks
  • Nonprofit, for-profit, and hybrid nonprofit/for-profit joint ventures
  • Mergers and acquisitions
  • Affiliations and partnerships among providers, and between providers and payers
  • Physician-hospital organizations, tax-exempt bond, and other financing arrangements
  • Professional service agreements

Health Care Operations

  • Tax-exempt and charitable organization matters
  • Corporate governance
  • Physician integration and staffing issues
  • Health care reform initiatives
  • Healthcare delivery issues, including telemedicine, genomics, and clinical research matters
  • Payer contracts

Regulatory Compliance

  • HIPAA/HITECH, Stark law, fraud and abuse, and Affordable Care Act compliance and state law issues
  • Regulatory investigations, repayment determinations, self-reporting, and settlement
  • Licensing and certificate-of-need matters
  • Professional licensing board disciplinary matters
  • Reimbursement program participation and payment issues
  • Policy review and revision for federal and state law compliance

Experience

Strategic Alliance of Community Hospitals and FQHCs
Hinckley Allen represented four community hospitals and three federally qualified health centers (FQHCs) in the creation of a clinically integrated network which negotiate and perform risk-sharing reimbursement contracts with commercial health insurers. Working collaboratively with a healthcare consultant, we guided the parties through the establishment of governance, financial, and clinical structure for their network which aligned their interests and established trust and a working relationship among them. A creative block-voting arrangement and deadlock provision enabled the parties to achieve parity in key decisions despite their disparate economic contributions to the endeavor. Our attorneys also helped these hospitals and FQHCs participate in an Accountable Care Organization in the Medicare AIM shared-savings program.

Establishment of Multi-Hospital Health System
We assisted a nationally recognized academic medical center in the establishment of a multi-hospital health system. We helped to create the parent company, and then assisted the General Counsel’s Office in bringing four nonprofit hospitals into the system through member-substitution transactions. Our lawyers drafted the template-affiliation agreement, conducted due diligence, and resolved identified concerns. We reviewed governance document amendments, assisted with state change of control processes, and advised the system and its new affiliates about necessary filings with state and federal reimbursement programs and tax authorities. We are now assisting the system with integration issues, including the centralization of legal services and risk management.

Development of “Baskets of Care” Program
We represented a major tertiary-care hospital in the development of a “baskets of care” program with a group of orthopedic surgeons and anesthesiologists. This innovative program, one of the first in the country, involves the development of clinically integrated total joint-replacement surgery packages, including orthopedic surgery, anesthesiology services, post-operative inpatient care, inpatient facilities and related inpatient care, and administrative services – all for a fixed fee. This arrangement creates opportunities for such healthcare providers to cooperate and innovate in connection with the development of improvements in healthcare quality and reduction of costs, such as the development and implementation of consistent clinical protocols, obtaining quality improvements and good clinical outcomes, enhancement of operational efficiencies and cost savings, sharing of financial risks relating to provision of care, increased patient satisfaction, and performance review and improvement.

Interrelated Hospital Affiliations with Bankruptcy Component
We represented a major Connecticut hospital system in two simultaneous affiliation transactions, one in which the client acquired a community hospital through a bankruptcy proceeding, and one in which the client joined a national hospital system. Our lawyers guided the client through the complexities of the community hospital’s bankruptcy proceeding, supported two concurrent certificate of need applications – and played a central role in drafting and negotiating affiliation agreements, conducting due diligence, advising the system regarding necessary filings with governmental authorities, and bringing the transactions to completion.

Acquisition of Dental Practice
We represented a dental practitioner associated with a major academic medical center acquire a prominent dental practice. Our work included advice on and negotiation of the asset purchase, provider, and consulting agreements as well as the associated restrictive covenant. We also provided advice on the business structure of the practice and its pension as well as financing arrangements.

Represented Physician Before Licensing Board
We defended a physician accused of misconduct before a state licensing board.

Case Studies

Case Study

Merger of two state affiliates of a national health organization

Hinckley Allen assisted two state affiliates of a national health organization in structuring their merger and obtaining the necessary regulatory and judicial approvals. Obtained approval in a contentious public hearing process before a state department of…

News & Insight

Firm News

Former Democratic Gubernatorial Candidate Jay Gonzalez Joins Hinckley Allen

April 8, 2019

Former Democratic gubernatorial candidate Jay Gonzalez will join Hinckley Allen to lead the Firm's work with public sector clients, bringing more than 20 years of public and private sector leadership and legal experience.Gonzalez will be a Partner in the F…

Firm News

Hinckley Allen Attorney Jared L. Shwartz Recognized with the Excellence in the Law Award

March 21, 2019

Hinckley Allen is proud to announce that Jared L. Shwartz has been selected to receive the Excellence in the Law Award in the “Up & Coming Lawyers” category. Presented by Massachusetts Lawyers Weekly, the Excellence in the Law Awards honors the ver…

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Publication

The Medicare Home Health Patient Driven Grouping Model: New Requirements for Home Health Care

September 5, 2019

The Medicare Home Health Patient Driven Grouping Model (PDGM), the most significant change to how agencies are reimbursed for home health services in 20 years, takes effect on January 1, 2020. Predicting the financial impact in transitioning to this new mo…

Publication

Tips for Recreational Marijuana Use Policies in “Social Model” Assisted Living Residences

May 7, 2019

As more states consider legalizing recreational marijuana, assisted living residences (ALRs) face a unique challenge: residents that chose to use this product.  Formal guidance regarding how ALRs should address a resident’s use of recreational marijuana…

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