The Academic Health Care Regulation and Transactions Team works closely with higher education clients on the intersection between higher education and health care. Affiliations between universities, hospitals and other university-affiliated providers require focus and experience with complex legal matters ranging from compliance with health care fraud and abuse laws, privacy and security regulations, to corporate and transactional counseling. University legal departments across the nation face challenging health care questions and conflicts that directly affect the well-being of their institutions’ patients and clinical faculty, and that have a critical impact on the financial sustainability of their faculty practice plans and teaching hospitals. Bryan Cave regularly collaborates with university attorneys, medical school deans and department heads to solve these matters in an efficient and productive manner.
Universities regularly engage in transactional and commercial legal matters involving the health care industry, whether they are entering into a combination or joint venture with their own affiliated teaching hospital or a community hospital, hiring or affiliating with additional providers, deploying a new electronic health record system, launching a comprehensive telemedicine service, entering into a physician leasing arrangements, establishing or adjusting compensation metrics for employed physicians, negotiating managed care contracts or other payer agreements for health care services, or leasing clinic or research space from affiliated hospitals. While such transactional activity often is characterized as general corporate activity, the regulatory framework governing such activity calls for careful planning and attention for compliance purposes. The Academic Health Care Regulation and Transactions Team engages in transactions involving health care providers and hospitals on a regular, ongoing basis and understands the key legal issues involved in achieving the clinical, financial and reputational outcomes desired by universities with faculty practice plans and hospital affiliations.
In addition, the Academic Health Care Regulation and Transactions Team advises clients on the health care regulatory matters that are at the core of the relationship between universities, health care systems and other providers. The potential for fraud and abuse as a result of violations of the False Claims Act, Stark Law, Anti-Kickback Statute and their state law counterparts confronts universities on a regular basis, and the exceptions and safe harbors that apply to universities are highly complex. Recognition of potential areas of risk, and carefully designed plans for compliance, are critical to minimizing legal risk for the long term.
Beyond the topics of fraud and abuse, universities also are regularly faced with HIPAA and HITECH matters and must have an effective compliance program implemented across the university. Such compliance programs should be tailored to address unfortunate but inevitable instances of HIPAA breaches and other, security incidents, and those programs also must establish effective plans for disaster recovery. They must be followed in accordance with their terms, thereby serving as the foundation from which a university can respond to events as they occur to reduce exposure and ensure to the fullest extent possible that issues are addressed timely and comprehensively.