Squire Sanders’ Triage Health Law Blog discusses the rapidly evolving health care industry in the wake of reform. Although it focuses on the new challenges and opportunities presented by recent government action, it also examines other aspects of today’s health care industry.
Squire Sanders’ Healthcare Litigation Team is at the forefront of the US healthcare industry. We counsel and defend healthcare clients faced with pending and threatened litigation and governmental investigations stemming from sweeping regulatory reform and significant advancements in science and technologies focused on patient care and services.
We offer clients a powerful mix of litigation and healthcare capabilities throughout the US to resolve multifaceted legal matters with a deep understanding of the healthcare business. Our healthcare litigators are an integral part of Squire Sanders’ nationally renowned (Top 10) Healthcare Practice. We represent clients in state and federal courts through jury and bench trials, in administrative procedures and hearings, and through the appellate process. These cases include a wide variety of lawsuits, including complex, bet-the-company litigation. We advise clients on liability and risk mitigation options related to corporate agreements, such as mergers, acquisitions and affiliations of all kinds, and on precedent-setting issues and rules shaping the industry, such as the establishment of, and guidelines for, accountable care organizations (ACOs), clinically-integrated networks (CINs) and direct contracting with self-insured business. We also counsel and defend clients against allegations of fraud and abuse and antitrust price-fixing, and assist clients as they navigate healthcare regulatory and licensure challenges at both the federal and state levels.
We represent both for-profit and nonprofit clients:
Why Choose Squire Sanders
- Mental health and substance abuse, rehabilitation, and skilled nursing facilities
- Health systems
- Physician hospital organizations, ACOs
- Physician organizations
- Pharmaceutical companies, pharmacies and pharmacists
- Senior and assisted living facilities
- Health insurers
- Third-party administrators
- Managed care networks
- Self-insured and insured companies offering health benefits to their employees
Scope of Services
- Deep understanding and involvement in the healthcare industry, healthcare reform and healthcare agencies at both the federal and state levels.
- Healthcare litigators, trial and regulatory lawyers who are:
- Former senior members of the Department of Justice (DOJ), including the Antitrust Division, and the US Attorneys’ offices, including the former healthcare fraud coordinator for the US Attorney's Office for the District of Columbia.
- A core part of Squire Sanders’ Healthcare Practice, which is ranked as one of the top 10 US healthcare law practices by American Health Lawyers Association (AHLA).
- Thought leaders and active members in the AHLA, including the AHLA’s incoming president.
- National and regional coordinating counsel to some of the largest healthcare companies in the US in multidistrict (MDL) and class action litigation.
- Highly coordinated representation of clients’ litigation and dispute resolution interests through our matrix of healthcare-related practices, allowing for more seamless and efficient client service.
Our healthcare litigation practice involves several core components:
Healthcare Provider Counseling
Managed Care Counseling
- Managed care payor disputes
- Medicaid and Medicare reimbursement appeals
- M&A issues including fraud and abuse
- Bankruptcy and restructuring litigation
- Corporate and corporate finance disputes
- Real estate-related litigation
- Labor and employment litigation
- Medical staff and credentialing
- Intellectual property litigation including theft of trade secrets, patent disputes and licensing litigation
- State Department of Health, Internal Revenue Service, Centers for Medicare & Medicaid Services, Drug Enforcement Administration, Federal Bureau of Investigation, and Health & Human Services investigations
- Administrative counseling, including certificate of need hearings
- Compliance investigations
False Claims Act and Qui Tam
- Reimbursement and insurance litigation including prompt pay and out-of-network rate disputes
- Employee health insurance and coverage disputes
- Managed care litigation
- Agent/broker compensation disputes
- Credentialing and termination of providers from managed care organizations and other network disputes
- Most favored nations clause audit and enforcement
- Department of Insurance and Department of Labor investigations and hearings
Healthcare-related Antitrust Issues
- Federal and state anti-kickback law
- Stark law and false claims matters
- Qui tam actions
- Department of Justice and states’ attorney general investigations and litigation
- Antitrust allegations, investigations and litigation
- Anticompetitive contracts
- Messenger model antitrust enforcement
- Mergers and acquisitions
- Allegations of market monopoly
- DOJ and states’ attorney general investigations and litigation
- Shareholder lawsuits including class actions
We also represent our healthcare clients in litigation related to additional issues such as:
- Challenges to IRS nonprofit status
- State and federal regulatory filings
- Risk assessment counseling including issues related to changing state and federal rules
- State licensure proceedings, disputes and appeals
- Product liability disputes