In the ever-evolving and highly regulated healthcare industry, litigation threats and challenges abound. Working collaboratively with other members of the firm’s extensive Healthcare Industry Group, McAfee & Taft’s experienced team of healthcare litigators actively represent, counsel and advocate for clients to resolve a broad range of business and operational disputes and threats, including regulatory compliance matters, professional and staff licensing issues, insurer and government audits, civil and criminal investigations, and commercial contract disputes.
Our clients include healthcare providers, hospitals and health systems, academic medical centers, clinics, surgical centers, long-term care and assisted living centers, home health agencies, physician groups, pharmacies, biotech companies, and pharmaceutical and medical device manufacturers and suppliers.
Representing businesses in the healthcare industry requires understanding that clients are not a “one size fits all,” that each client is unique, and that each client’s litigation circumstance will present unique challenges that requires our litigators to think outside the box to reach a successful resolution. It also requires our litigators to have an understanding of the complex regulatory environment in which healthcare businesses operate. Our litigators are aided in this respect by McAfee & Taft’s cooperative and integrated firm structure, which ensures a team-driven approach to all litigation matters and permits litigators to work alongside our attorneys who have the deep regulatory expertise necessary to inform litigation strategies.
This broad base of knowledge means we are effective and efficient. We can evaluate your litigation matter and give you advice on how to effectively move forward. We know the difference between a litigation matter that should be fought, and a litigation matter that warrants seeking an early resolution outside of an administrative hearing or trial. We understand when an aggressive litigation policy is an appropriate way to address a conflict, and when to use our resources to seek an early resolution because such is preferable. In these instances, our broad base of knowledge, our experience in working with regulatory agencies, and our reputation for toughness and thoroughness helps you reach a more favorable result because the regulatory agencies, government investigators and lawyers, and opposing counsel understand that when we are involved, they will be dealing with reputable counsel thoroughly prepared to fully represent your interests.
A representative sampling of the types of matters handled by our lawyers includes:
- Representation of all types of healthcare industry participants in handling issues related to medical staff, including medical staff records and documentation, medical staff hearings, representing practitioners before licensing boards, advising on credentialing and admitting privilege issues, peer review issues, and employment issues for licensed practitioners and other staff.
- Representation of Medicare and Medicaid providers in qui tam actions brought under the False Claims Act by private parties as relators/whistleblowers.
- Representation of healthcare providers in responding to civil investigative demands, grand juries, government investigations, audits involving improper billing practices, and civil and criminal prosecutions involving Medicare and Medicaid fraud and False Claims Act cases, antitrust, anti-kickback and Stark claims, and other white collar crimes brought by the U.S. Department of Justice (DOJ), Office of Inspector General (OIG), and state attorneys general.
- Representation of healthcare providers in defense of search warrants, negotiations with prosecutors, and suspension issues.
- Representation of healthcare providers in responding to subpoenas requesting protected health information (PHI) and electronic protected health information (ePHI) under the Health Insurance Portability and Accountability Act (HIPAA).
- Representation of a variety of providers in addressing administrative rulings from regulatory agencies, including appeals before administrative law judges on varied topics such as licensure, certification, compliance, demands for recoupment, and other matters.
- Representation of physicians, hospitals, long-term care and assisted living centers, and medical and dental professionals against claims of malpractice and negligence, including those involving standard of care claims, negligence in peer review and negligent credentialing claims, misdiagnosis and failure to diagnose claims, and bad faith issues.
- Representation of healthcare providers and other healthcare industry businesses in simple and complex commercial litigation matters, including enforcement of agreements, executive compensation issues, health plan contracting, HMO and health plan regulation, insurance and payer contracts, reimbursement issues, and medical and record documentation to include issues related to HIPAA.
- Representation of leading manufacturers of pharmaceutical drugs and medical devices in product liability, mass torts, and class action litigation.
- Representation of charitable healthcare providers in securing ad valorem exemptions.