Health Law

Aligning the participants in your intricate health care system

With more than 50 years of perspective, Shumaker advises health care clients—practitioners, providers, and payors—on matters as they arise, while proactively alerting them to opportunities and potential pitfalls on the horizon.

Our extensive experience with diverse health care clients helps us understand, anticipate, and respond to strategic concerns posed by a dynamic regulatory and business environment. We serve a range of clients—from large insurers and hospital systems to individual practitioners—delivering the counsel they need to mitigate risks and achieve the business goals required to continue their work in keeping people healthy. Clients benefit from our knowledge and experience, as well as our willingness to work with in-house personnel and counsel to efficiently pursue your objectives.

Representative Clients:

• Hospitals, health systems, and health care networks
• Physicians and physician groups
• Academic medical centers and research hospitals
• Ambulatory surgery centers
• Medical transportation companies
• Imaging and other diagnostic facilities
• Dialysis and radiation therapy facilities
• Nursing and assisted living facilities
• Pharmacies and medical equipment suppliers
• Concierge medical practices
• Tissue banks and cancer treatment centers
• Billing companies

To keep you focused on providing care, Shumaker takes on a host of support functions:

• Accreditation (joint commission, Det Norske Veritas (DNV), etc.)
• Acquisitions, affiliations, and general corporate matters
• Antitrust
• Assistance with Corporate Integrity Agreements (CIAs)
• Behavioral health
• Bioethics
• Board governance
• Certificate of need (preparation, hearings, and administrative litigation)
• Clinical Co-Management Agreements
• Clinical research
• Coding
• Compliance advice
• Compliance program development
• Compliance programs, including health care providers and health plans
• Contract and grant review
• Credentialing (payor and facility)
• Drafting and review of contracts, letters of intent, employment agreements, and other arrangements
• False claims act defense
• Food and Drug Administration (FDA) (drug, device, and emergency use authorization)
• Foundations
• Fraud and abuse advice
• Fraud and abuse, self-referral, and false claims issues
• Governance advice
• Government regulatory investigations (Civil Investigative Demands (CIDs), audits, interviews, etc.)
• Health care bond issuance
• Health care litigation
• Health information privacy and security
• Health information technology
• Health law strategic advice and counsel
• Health Insurance Portability and Accountability Act (HIPAA) program reviews, breach investigations/reporting, and response
• Human resources
• Immigration
• Internal and external investigations, audits, and monitoring
• Internal investigations
• Legislative advice/lobbying
• Licensure, accreditation, certification, change of ownership, and certificate of need issues
• Licensure, permits, registrations (state and federal)
• Litigation (premise liability, product liability, contractual, commercial, etc.)
• Medicare Access and Chip
• Medicare Access and CHIP Reauthorization Act (MACRA)
• Managed care contracting
• Management services arrangements
• Medical lien resolution
• Medical malpractice defense
• Medical staff bylaws
• Medical staff matters, including bylaws, reviews, and hearings
• Medical staff peer review and litigation
• Medicare and Medicaid reimbursement and enrollment
• Nonprofits
• Operational issues, including quality assurance and risk management
• Operations matters
• Patient issues (decision-making, end-of-life, complaints, etc.)
• Patient safety
• Payor contracting and provider network design
• Physician acquisitions/integration
• Physician contracting
• Premises security (health care providers)
• Private equity transactions
• Procurement
• Professional services agreements
• Provider-payor enrollment
• Provider-payor disputes
• Quality/Utilization Review (UR)
• Qui tam investigations
• Qui tam litigation
• Recovery Audit Contractor (RAC) appeals
• Reimbursement/revenue cycle
• Risk management
• Self-insurance
• Service as outside general counsel
• Tax exemption issues, including maintenance of 501(c)(3) status and tax-exempt financing
• Telemedicine
• Zone Program Integrity Contractor (ZPIC) audits