Serving as leaders in healthcare innovation, Leech Tishman Nelson Hardiman provides deep insight and strategic counsel on the new era of value-based care (VBC). Rapidly supplanting the waning “fee-for-service” era of volume-based reimbursement, we assist healthcare providers in managing risk and optimizing VBC models in their practices.
We advise on risk management issues, including data sharing and usage, reimbursement structures and cost controls, technological initiatives to facilitate patient engagement, and effective practice integration. Our attorneys help integrative health systems identify risk and optimize value to efficiently realign and thrive in the evolving landscape of value-based care.
- Advised on operational matters, including corporate reorganizations and integrated health systems
- Served as in-house counsel for several nonprofit integrated health systems, advising on business planning and structuring, contract negotiations, and a broad range of reimbursement and regulatory compliance and strategy
- Defended integrated health systems in complex federal and state FCA actions involving claims for allegedly non-reimbursable, unnecessary, or inflated services and costs
- Structured factoring transaction for six healthcare providers and three investment firms involving $20 million in workers’ compensation accounts receivable in response to changes introduced by California Senate Bill 1160
- Advised multiple integrated health systems on HIPAA privacy and data security breaches and implemented HIPAA compliance programs for numerous entities, including developing a patient data registry that tracked quality assurance and outcome measurement
- Advised a digital health company regarding compliance and risk management strategies in servicing Medicare beneficiaries and contracting with Medicare and in-network healthcare providers
- Negotiated and implemented a corporate integrity agreement on behalf of an integrated health system, in response to a federal investigation of Stark/Anti-Kickback Statute violations