Physician and Health Law

Helping You Navigate the Rapidly Evolving Healthcare Landscape

 Waldheger • Coyne has been at the forefront of representing physicians’ interests since its inception. We understand the entire process of the delivery of healthcare services from licensure, ethics, and staff matters, to federal regulation, payor contracting and relationships with major health systems.

Frequently, the issues facing a medical practice, whether small or large, involve the interplay of many different laws and regulations, as well as a complete understanding of the payment and compliance system. This involves understanding all federal and private payment systems, the issues surrounding IT and billing, and payor contracting. Our attorneys are known as leaders in these areas, and are often engaged as special counsel by other law firms to work on these matters for their clients.

We understand the inner workings of a medical practice, including the relationships between the physicians defined in their employment contracts, buy-sell arrangements, mergers and acquisitions, and the structuring of buy-in and buy-out arrangements, and have helped hundreds of practices navigate the changing environment in health care, including issues related to electronic health records.

Relationships are vital in healthcare. We are well known and respected by all of the major health systems and insurers and thus can effectively represent your interests in all types of negotiations with them.

We have helped hundreds of mid-sized to large medical practices redesign themselves by using fully and partially integrated joint ventures, Networks, Professional Service Agreements (PSA’s), risk-sharing and bundled payment contracts, gain-sharing, point of service contracts, RVU models, and bonus structures for cost savings.

In addition, we take pride in the ancillary medical facilities and services we represent, including Ambulatory Surgery Centers (ASCs), Dialysis Centers, MRI and CT facilities and Physical Therapy.

Areas of Experience: Physician & Health Law

  • Accountable Care Organizations (ACOs)
  • Mergers and Acquisitions of Practices and facilities
  • Private Equity Acquisitions and Rollover Equity
  • Design and negotiation of Joint Ventures between providers and with Health Systems
  • Medical Homes and Centers of Excellence Third-party payor and insurance contract negotiations
  • Ambulatory surgery centers
  • Ancillary service centers – imaging, laboratory, and physical therapy
  • Physician-hospital joint ventures
  • Physician compensation arrangements and employment contracts
  • Physician practice transitions and employment negotiations
  • Design of Compensation arrangements for physician and ancillary services
  • Malpractice insurance and alternatives including Captives
  • Audits and Disputes with Medicare, Medicaid, and third-party payors
  • Stark Law and Anti-Kickback Law analysis and compliance
  • Physicians networks and antitrust law compliance – IPC, IPG, IPA, and PO
  • Physician group practice development and representation
  • Facility accreditation and compliance – CORF, CLIA, CAP, and JCAHO
  • Physician practice management companies – IPSO, PPM, and MSO
  • Research, pharmaceutical, and DME contracts
  • Medicare and payer audits