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Barclay Damon has one of the leading health care teams in the Northeast. Our rapidly expanding bench of health care attorneys provides sophisticated counsel to businesses and professionals on regulatory, transactional, and litigation matters.

Overview

Barclay Damon has one of the leading health care teams in the Northeast. Our rapidly expanding bench of health care attorneys provides sophisticated counsel to businesses and professionals on regulatory, transactional, and litigation matters. We immerse ourselves in our client’s business and counsel them using keen industry insight. That understanding is enhanced by attorneys on our team who have previously held positions with federal and state regulatory and enforcement bodies.

We are proud to serve as advocates and advisors to the full spectrum of the health care industry:

  • Hospitals, health systems, and physicians
  • Post-acute care providers
  • Developmental disability and behavioral health providers
  • Health Information Exchanges (HIEs) and data privacy and security

Regulatory and Compliance Matters

We routinely assist clients in addressing a range of regulatory and compliance issues, including:

  • Clinical alignment and network development
  • Corporate compliance
  • False Claims Act and anti-kickback and self-referral laws
  • FDA compliance
  • HIPAA and health-information privacy and security
  • Licensure, Certificate of Need (CON), and surveys
  • Managed-care contracting
  • Medicare, Medicaid, and other payor reimbursement
  • Patient care and end-of-life issues
  • Professional licensure
  • Telehealth

Corporate and Business Transactions

We are valued business advisors to our clients. Our attorneys have the unique combination of transactional and health care experience to be able to handle sophisticated transactions.

We are routinely called upon by clients for assistance with the following:

  • Antitrust
  • Affiliations and network development
  • Contract preparation, review, and negotiation
  • Corporate governance
  • Corporate tax and tax exemption
  • Due-diligence regulatory reviews
  • Entity formation and restructuring
  • Joint-venture arrangements
  • Mergers, acquisitions, and divestitures
  • Project financing, planning, and implementation

Government and Payor Audits, Investigations, and Litigation

Our attorneys provide strategic advice and advocacy to clients involved in government and payor audits and investigations. In the event an audit or investigation progresses to an administrative or judicial proceeding, we connect with the litigation attorneys on the firm’s health care controversies team.

Our representative experience includes:

  • Investigations, audits, and regulatory proceedings before the:
  • HHS Office of the Inspector General (HHS OIG)
  • NYS Attorney General’s Bureau of Internet and Technology
  • NYS Attorney General’s Medicaid Fraud Control Unit (MFCU)
  • NYS Department of Education (SED)
  • NYS Department of Health (DOH)
  • NYS Department of Health Office of Professional Medical Conduct (OPMC)
  • NYS Education Department Office of the Professions (OP)
  • NYS Justice Center for the Protection of People With Special Needs
  • NYS Office for People With Developmental Disabilities (OPWDD)
  • NYS Office of the Medicaid Inspector General (OMIG)
  • NYS Office of Mental Health (OMH)
  • NYS Office of Alcoholism and Substance Abuse (OASAS)
  • Private Payors
  • US Department of Health & Human Services’ Office of Civil Rights (HHS OCR)
  • US Department of Justice (DOJ)
  • Article 78 proceedings challenging state-agency determinations
  • Crisis response and reporting related to data-breach incidents
  • Fraud and abuse allegations
  • Whistleblower complaints
Team Members
Representative Experience
  • Provided risk-management services to MLMIC-insured hospitals, clinics, nursing homes, surgery centers, physicians, and dentists. Also provided legal guidance to facilities and professionals on a wide range of organizational and patient care issues, including HIPAA and the disclosure of medical information under NY law, EMTALA, peer review, consent for treatment, professional liability, patient discharge/abandonment questions, and the scope of practice.

  • Assisted a NYS care coordination organization (CCO) with health care compliance matters during its initial formation and once operational, including assisting with vendor contracting, reviewing data-use agreements and security attestations, corporate matters, HIPAA compliance and policies, and preparing a corporate compliance plan and related policies.

  • Served as outside counsel to a residential health care facility operator in the $7.5 million sale of a facility and related real property.

  • Served as outside general counsel to a regional pharmacy, pharmaceutical products, and long-term and assisted living consulting company in a $14 million sale of assets.

  • Successfully defeated a $1.6 million liability arising from an Office of Medicaid Inspector General (OMIG) finding that an intellectual/developmental disability (I/DD) agency documentation was insufficient to support reimbursement it received for services provided.

  • Successfully challenged improper Medicaid rates for an intellectual/developmental disability (I/DD) agency that was acquired by a larger agency. 

  • Prepared a HIPAA business associate manual for a Fortune 100 company's electronic medical record vendor and provided training.

  • Represented a client in an $85 million transaction involving the sale of a large medical practice specializing in urology and radiation oncology to a captive medical practice controlled by a large regional hospital system together with all related real estate owned by entities affiliated with the practice. The real estate was purchased by a local developer and leased back to the captive practice pursuant to a master lease.

  • Designed corporate structures for an intellectual and developmental disabilities (I/DD) agency to facilitate the telehealth delivery of health care services.

  • Performed all legal responsibilities related to the $225 million development, construction, and financing of a children's hospital, including negotiating and preparing all development, design, and construction contracts and preparing all loan and real property documentation related to HUD-insured mortgage financing and EB-5 financing.

  • Assisted with the restructuring of all secured and unsecured debt related to the $25 million merger of two hospitals, including redeeming and reissuing civic facility bonds, coordinating consents from the PA and NY Departments of Health, and handling all real estate and title insurance work related to financing.

  • Served as outside general counsel to a performing provider system (PPS) in the acquisition of a Rochester-area regional health home network.

  • Served as outside general counsel to a WNY behavioral health provider in its merger with a regional child and adolescent behavioral health provider and in obtaining related regulatory approvals.

  • Served as outside general counsel for nursing home facilities and related sellers in a $45 million multi-year, progressive equity sale of nursing home entities and in the NYS Department of Health (DOH) regulatory approval process.  

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