Hospitals and Health Systems

PROVEN COUNSEL

We partner with hospitals, health systems and provider organizations across the United States and around the world on all aspects of healthcare legal, investment, operations and regulatory matters. As the top-ranked healthcare law firm, we advise clients on all elements of the health industry. The results are operational efficiencies and reduced costs, optimized investments in technology and innovation, and improved patient care and safety.
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Areas of Interest

innovation Centers

Navigate the many regulatory, legal and business requirements your revolutionary developments bring including:

  • Intellectual Property
  • Tax and Tax Exemption
  • Data Privacy And Security
  • Employee Benefits
  • FDA
  • Conflicts Of Interest and More

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coronavirus resource center

The Coronavirus (COVID-19) pandemic has suddenly and permanently changed the way we deliver, consume and pay for healthcare services. To help you understand these changes McDermott has developed a COVID-19 resource center where you can find current updates and analysis.

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collaborative transformation

Unexpected partners are joining forces to innovate in bold and surprising ways, as they do, they face some of healthcare’s toughest challenges. We’re here to help with mergers, acquisitions, joint ventures and all other types of innovative collaborations.

  • Regulatory Compliance
  • Digital Health
  • Intellectual Property
  • Investment
  • Tax
  • Licensing
  • Litigation

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Digital healtH

At the forefront of the transforming Digital Health landscape McDermott works with hospitals and health systems to make sense of the changing digital landscape and implement strategies and tools that align with the most recent regulatory requirements.

  • Telehealth/Telemedicine
  • Health Information Technology
  • Big Data and Data Strategies
  • Data Privacy/Security HIPAA and State Laws
  • Intellectual Property

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Consolidation and RestructurinG

Consolidating and restructuring hospital and health systems is a complex process that involves a range of critical planning and coordination steps to ensure the health, welfare and safety of hospital patients and mitigate legal, financial and other risks for the hospital and its officers and directors.

Corporate Governance

Healthcare corporations and their leadership face a host of legal and reputational challenges that must be addressed strategically and proactively. Our healthcare governance team, provides engaging, issue-based resources on the risk areas corporations face and how the general counsel’s office and the board can address them.

  • Quality and Patient Safety
  • Fiduciary Considerations
  • Protocols and Structure
  • Culture and Leadership for Radical Decision Making

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general counsel’s corner

WHAT CMS’ SPLIT BILLING PROPOSAL MEANS FOR HEALTH PROVIDERS

August 2021 

In its 2022 Medicare physician fee proposed rule the Centers for Medicare and Medicaid Services (CMS) provided its proposal for regulations codifying its long-standing guidance on billing for split, or shared, evaluation and management visits. Split or shared visits are evaluation and management visits provided in part by both physician and nonphysician practitioners. If finalized, the new regulations would make changes to the following aspects of split billing:

  • Who can bill
  • Setting of care
  • Definition of “same group”
  • Medical record documentation
  • Claim modifier
  • Critical care

Nonphysician practitioners have and continue to be increasingly utilized in both the physician office and in facility settings to furnish care to patients. The thoughtful use of nonphysician practitioners may result in more efficient and comprehensive care, but the supervising and billing requirements that must be met in order to properly bill Medicare vary depending on the setting.

This is further complicated by the expansion in hospital outpatient clinics, which may make it difficult for a patient or practitioner to differentiate between a physician office and a hospital outpatient setting — notwithstanding the material differences in Medicare billing and coverage policies for services furnished in each setting.

Specifically, these proposed rules may impact:

  • Reimbursement opportunities for services primarily performed by nonphysicians
  • Time spent documenting activities by physicians, nonphysicans and administrative personnel
  • Types of care services eligible for spit billing
  • Stark Law

Providers have an opportunity to provide feedback about the proposed regulations, including providing input to CMS on concepts that have long been unclear, such as the definition of “same group.”

Given the increasing involvement of nonphysician practitioners in care furnished in facility settings, interested providers should actively engage with CMS to ensure that the regulations are developed in a manner that will best situate providers to implement the revised policy for split visits. Comments to the proposed rule must be submitted by Sept. 13.

For guidance on submitting comments to CMS or how this proposed rule may impact your hospital or health system, please contact your regular McDermott attorney or Emily Cook.

Articles

WHAT CMS’ SPLIT BILLING PROPOSAL MEANS FOR HEALTH PROVIDERS

Law360
August 20, 2021

CMS SEEKS COMMENTS ON REQUIREMENTS FOR RURAL EMERGENCY HOSPITALS AS A NEW MEDICARE PROVIDER CATEGORY
July 30, 2021
CMS PROPOSES NEW REGULATION TO CLARIFY PHYSICIAN AND NPP “SPLIT (OR SHARED)” BILLING POLICY

July 15, 2021

CMS PROPOSES HEIGHTENED PENALTIES AND ADDITIONAL REQUIREMENTS UNDER THE HOSPITAL PRICE TRANSPARENCY RULE

July 20, 2021

EXECUTIVE ORDER ENCOURAGES FTC, DOJ TO ADDRESS HOSPITAL CONSOLIDATION, VIGOROUSLY ENFORCE ANTITRUST LAWS

July 15, 2021

OSHA MAINTAINS COVID-19 SAFETY PRESSURE ON HEALTHCARE EMPLOYERS DESPITE CHALLENGES FROM ALL SIDES

July 14, 2021

FIDUCIARY ENGAGEMENT IN ARTIFICIAL INTELLIGENCE INNOVATION: A GOVERNANCE IMPERATIVE

Health Law Connections, June 2021

CMS RESTARTS HOSPITAL SURVEY ACTIVITIES DELAYED BY COVID-19

March 31, 2021

340B IN 2021: WHAT COVERED ENTITIES AND THEIR PARTNERS NEED TO KNOW NOW

March 31, 2021

Podcasts

Episode 11: A Lender’s Perspective on Healthcare PE Deals
Driving the Deal: Clearing Regulatory Hurdles in Public Hospital M&A
AFTER THE CURVE PODCAST: FOCUS ON PROVIDERS

Driving the Deal: Public Hospital M&A and Stakeholder Buy-In

Dealmaking in the Sunlight: Navigating Public Hospital M&A

Videos

REGULATORY DISPUTES WITH HHS: WHEN TO NEGOTIATE AND WHEN TO LITGATE

March 25, 2021

340B IN 2021: WHAT COVERED ENTITIES NEED TO KNOW NOW

March 18, 2021

ANSWERING PROVIDERS’ VACCINATION QUESTIONS

FEBRUARY 2, 2021

DATA LICENSE AGREEMENT LITIGATION – WHAT YOU NEED TO KNOW

OCTOBER 28, 2020

PAVC TELEHEALTH: PERSPECTIVES ON THE PATIENT EXPERIENCE DURING COVID-19 AND BEYOND

OCTOBER 29, 2020

APIS AND INFORMATION BLOCKING: WHAT PROVIDERS NEED TO KNOW

OCTOBER 13, 2020

Structuring Your Innovation Center Investment

Special Reports

KEY TAKEAWAYS: HOSPITALS & HEALTH SYSTEMS INNOVATION BOOTCAMP FOR IN-HOUSE COUNSEL
KEY TAKEAWAYS: REMOTE WORK FOR HOSPITALS AND HEALTH SYSTEMS
ESTABLISHING A CPOD MODEL: 5 INITIAL STEPS FOR EMPLOYERS
PROVIDER RELIEF FUND (PRF): GENERAL AND TARGETED DISTRIBUTIONS

EVENTS

HEALTH ANTITRUST ENFORCEMENT: MUST-KNOW CHANGES FROM THE BIDEN ADMINISTRATION

September 23, 2021
11:30am – 12:30pm CT

LEARN MORE & REGISTER HERE

2020 HOSPITAL & HEALTH SYSTEM INNOVATION SUMMIT

This summit will give C-suite executives, in-house counsel, investors and other healthcare leaders the insights they need to position their organizations to innovate, collaborate and grow even in the midst of disruption.

VIEW RECORDING

Hospitals & Health Systems Team Leads

Kerrin B. Slattery
Partner | Chicago

Charles Buck
Partner | Boston

Hospitals & Health Systems Team

Evelyn Atwater
Associate
Gary Davis
Partner
Dexter Golinghorst
Associate
Joshua Hill
Partner
Adam Marks
Partner
James Owen
Partner
Charlotte Roork
Paralegal
Jessica Jung
Associate
Marika Miller
Associate
Emily Palmer
Associate
Allyn Rosenberger
Law Clerk

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