Health Care
Recognized for our extensive experience advising and representing providers, payors and investors in the health care industry, the firm has substantial experience with the regulatory, licensing and operational issues affecting our clients. Our expertise enables us to provide creative, innovative, practical and often times outside-the-box solutions, whether in transactional, regulatory and/or litigation matters. In an industry as regulated as health care, it is critical to have the right counsel to structure compliant business arrangements rather than waiting to seek guidance when a problem arises. Structuring arrangements to comply with applicable laws and regulations, including Federal and State fraud and abuse, privacy, fee-splitting and corporate practice of medicine laws, is never an afterthought at Tenzer and Lunin. Just as important for our clients, we work to continuously stay abreast of the latest regulatory and legislative developments impacting our clients, and advising accordingly.
Our health care clients include nursing homes, adult homes, home care providers, hospitals, physicians, physician groups, management services organizations (MSOs), pharmacies, medical laboratories, equipment suppliers, community residences, diagnostic and treatment centers, treatment programs, concierge medicine groups, managed care entities, independent practice associations, agencies serving people with developmental disabilities and other health care providers.
Compliance and Licensure
We work with our clients from their earliest stages forming business ideas to structuring business transactions and navigating licensure questions as well as ongoing compliance concerns as (and before) they arise.
We regularly counsel our clients on the myriad of regulatory requirements impacting health care providers, their transactions and their day-to-day operations.
The attorneys at Tenzer and Lunin work with clients on licensing matters, changes of ownership and Certificate of Need applications, third-party reimbursement, including audits, Federal and State anti-kickback, self-referral, fraud and abuse issues, corporate compliance and risk management, formation of managed care entities, Medicare and Medicaid program compliance, and HIPAA and other regulatory compliance.
Health care Transactions
Tenzer and Lunin has structured many purchase and sale transactions for health care providers, lease arrangements, joint ventures, and management and consulting agreements. We are able to leverage our combination of expertise in both the regulatory and the corporate and business aspects of these transactions to successfully negotiate and document a variety of arrangements on behalf of our clients, frequently providing new and improved ways of structuring transactions that can be a “value add” not only for our clients but for their counterparties to a transaction as well. We are involved in transactional matters in New York and nationally, working with local counsel when necessary to address any State specific issues.
In addition to negotiating transactions of licensed health care facilities, we also work with medical practice groups and individual physicians, for instance in acquiring other practices or groups, selling their practices to hospitals or other providers and otherwise engaging in consulting, employment or joint venture arrangements. We counsel our clients on how best to maximize and protect the value they have built in their practices.
We are also often engaged for our expertise relating to healthcare financing, including HUD-insured financing, and senior and subordinate financing. See our “Real Estate and Financing” practice area summary for additional information.
See our “Corporate and M&A” practice area summary for additional information.
HIPAA Compliance
See our “Technology, Privacy and Data Security” practice area summary for additional information.
Investigations and Enforcement
In addition to our pro-active approach to ensuring our clients enter into legally compliant business arrangements, we also work with our clients when investigations arise, at both the Federal and State level. We counsel our physician clients and represent them in connection with investigations by the New York Office of Professional Medical Conduct. In addition, with the tightening reins of lowered reimbursement for services and an increase in fraud and abuse investigations, we assist providers in reimbursement disputes and challenges from public and private payors. Whether the matter involves recoupment of payments, penalties for improper billing, or penalties resulting from government investigation into billing practices, we handle these enforcement matters to protect providers from the complexities of the regulatory framework.
See our “Litigation and Dispute Resolution” practice area summary for additional information.
Some recent representative health care matters include the following:
Represented a company providing medical treatment services at skilled nursing facilities, counseling the structure of arrangement to comply with Federal and State Stark and anti-kickback laws.
Represented a group in its formation of an independent practice association (IPA) in New York, including securing receipt of regulatory approvals, and negotiating arrangement and agreements with multiple managed long term care companies.
Represented a physician in negotiating hospital employment agreement as well as development agreements and relationships with medical device companies.
Represented a Public Health Law involuntary receiver in the course of its receivership at a skilled nursing facility, navigating the legal issues associated with the operation of a skilled nursing facility in receivership, including guidance in the rights and obligations with respect to the Medicare and Medicaid programs, pre-receiver liabilities, employee and labor relations.
Additional representative work includes acting as counsel for a group purchasing organization, involved in negotiating contracts with vendors and skilled nursing facilities; preparation of Federal and State law compliant compliance plans for multiple skilled nursing facilities; submitting and prosecuting various certificate of need applications; representation of clients in connection with reimbursement audits by the New York State Office of Medicaid Inspector General as well as by the Medicaid program.