
Contact
- 716.848.1369
Using a multidisciplinary approach, the attorneys at Hodgson Russ provide counsel to a wide range of health care providers, including hospitals, skilled nursing facilities, assisted living providers, home health agencies, hospices, clinics, ambulatory surgery centers, behavioral health providers, clinical laboratories, pharmacies, and individual practitioners. We represent nonprofit, for-profit, and public health care organizations, including some of the largest hospital systems in New York State. We assist with corporate, transactional, regulatory, reimbursement, compliance, enforcement, and litigation matters. With a broad understanding of the New York regulatory landscape, we help clients anticipate and respond to the increasingly complex rules governing the delivery, financing, and regulation of health care services.
Audits, Investigations, and Appeals
We represent health care providers in Medicare and Medicaid audits, investigations, and appeals, including Medicare appeals before the Provider Reimbursement Review Board. We also represent health care providers in government investigations and enforcement proceedings before the New York State Department of Health, Office of the Medicaid Inspector General, and Medicaid Fraud Control Unit; the Health and Human Services Office of Inspector General and Centers for Medicare and Medicaid Services; and the U.S. Department of Justice.
Health Care Litigation and Dispute Resolution
Hodgson Russ represents health care providers in federal and state court litigation, administrative challenges to governmental action, and arbitration proceedings with managed care organizations.
Health Care Mergers, Acquisitions, and Joint Ventures
We structure health care mergers, acquisitions, reorganizations, and joint ventures. We advise on the application of New York’s certificate of need requirements to proposed combinations. Our attorneys also provide guidance on antitrust, corporate, regulatory, and tax issues.
Health Care Transactions, Operations, and Contracts
We advise health care providers on contracting and corporate structuring issues and assist providers with analyzing and negotiating managed care contracts and forming independent practice associations (IPAs). We counsel clients on issues related to fraud and abuse, including the physician self-referral law (Stark) and the anti-kickback statute.
Health Care Reform
Hodgson Russ assists health care providers in responding to health care reform initiatives, such as the delivery system reform incentive payment (DSRIP) program, accountable care organizations (ACOs), and health homes. We also provide guidance on accessing reimbursement incentives (such as Medicaid Redesign Team (MRT) initiatives).
HIPAA and Privacy Issues
Our attorneys advise and represent covered entities and business associates on privacy matters under the Health Insurance Portability and Accountability Act (HIPAA), the federal rules governing the confidentiality of substance abuse treatment services, and New York State confidentiality laws. We assist providers in negotiating contractual relationships and managing privacy breaches and breach notifications.
Licensure, Certification, and Surveys
We represent skilled nursing facilities challenging survey deficiencies through the informal dispute resolution (IDR and independent IDR) processes and administrative appeals to the Departmental Appeals Board of the U.S. Department of Health and Human Services.
Medicare, Medicaid, and Other Reimbursement Issues
We advise health care providers on Medicare and Medicaid billing and reimbursement issues and assist them in analyzing the reimbursement consequences of alternative business structures. We represent providers in Medicare and Medicaid audits and appeals, including Medicare appeals before the Provider Reimbursement Review Board.
Nonprofit Organization and Governance Issues
We advise nonprofit health care boards on best practices in corporate governance and regulatory compliance. Our attorneys assist in the development of charters and bylaws and the formulation of compliance policies. We also assist in conducting internal investigations relating to potential compliance violations, including whistleblower allegations, and in responding to inquiries from governmental agencies.
Physicians, Licensed Professionals, and Group Practice Issues
We negotiate the purchase and sale of physician practices and advise on physician recruitment issues. Our attorneys prepare contracts to comply with fraud and abuse, IRS, and other applicable guidelines. We advise facility administration, physicians, and other licensed professionals on contract negotiations, third-party payor reimbursement, purchases and sales of assets, and medical staff credentialing and disciplinary issues. We represent physicians and other licensed health care professionals in disciplinary proceedings before their respective licensing boards.
Regulatory Compliance
We counsel providers in the development, implementation, review, and revision of their compliance programs, which are mandatory in New York under Social Services Law § 363-d and 18 NYCRR Part 521. We provide guidance on internal audit and monitoring, risk assessment, and corrective measures, such as self-disclosure, employee discipline, and enhanced training. We advise clients on privacy matters under federal and New York State laws and on issues related to fraud and abuse, including the physician self-referral law (Stark) and the anti-kickback statute.
Some of the many services we offer to our health care clients include:
- Representation in Medicare and Medicaid audits, investigations, and appeals, including Medicare appeals before the Provider Reimbursement Review Board
- Representation in government investigations and enforcement proceedings before the New York State Department of Health, Office of the Medicaid Inspector General, and Medicaid Fraud Control Unit; the HHS Office of Inspector General and Centers for Medicare and Medicaid Services; and the U.S. Department of Justice
- Representation in federal and state court litigation, administrative challenges to governmental action, and arbitration proceedings with managed care organizations
- Assistance in structuring mergers, acquisitions, and joint ventures
- Advice on the application of New York’s certificate of need requirements
- Advice on contracting and corporate structuring issues, including the physician self-referral law (Stark) and the anti-kickback statute
- Assistance with analyzing and negotiating managed care contracts
- Advice on responding to health care reform initiatives, such as the delivery system reform incentive payment (DSRIP) program and accountable care organizations (ACOs), and in accessing reimbursement incentives, such as Medicaid Redesign Team (MRT) initiatives
- Advice and representation of covered entities and business associates on privacy matters under the Health Insurance Portability and Accountability Act (HIPAA), the federal rules governing the confidentiality of substance abuse treatment services, and New York State confidentiality laws, including the negotiation of contractual relationships and management of privacy breaches and breach notifications
- Representation of skilled nursing facilities seeking to challenge survey deficiencies through the informal dispute resolution (IDR and independent IDR) processes and to pursue administrative appeals to the Departmental Appeals Board of the U.S. Department of Health and Human Services
- Advice on Medicare and Medicaid billing and reimbursement issues
- Advice to nonprofit health care boards on corporate governance and compliance best practices
- Assistance in developing corporate charters and bylaws, formulating compliance policies, and performing self-assessments
- Advice on the fiduciary obligations of directors and issues related to executive compensation
- Assistance in conducting internal investigations relating to potential compliance violations, including whistleblower allegations, and responding to inquiries from governmental agencies
- Representation of physicians and other licensed health care professionals in disciplinary proceedings before state licensing boards
- Advice to facility administration, physicians, and other licensed professionals on contract negotiations, third-party payor reimbursement, purchases and sales of assets, and medical staff credentialing and disciplinary issues
- Guidance in the development, implementation, review, and revision of provider compliance programs, required under Social Services Law § 363-d and 18 NYCRR Part 521
- Guidance on internal audit and monitoring, risk assessment, and corrective measures, such as self-disclosure, employee discipline, and enhanced training
Our Healthcare Practice attorneys work together with attorneys in other key practice areas, including corporate, real estate, finance, tax, labor and employment, bankruptcy, immigration, intellectual property, and litigation, to offer health care providers the coordinated and informed counsel they need to meet their legal challenges.
- Successful Challenge to Immediate Jeopardy Deficiencies for Nursing Home Client
- Another Successful Challenge to Immediate Jeopardy Deficiencies for Skilled Nursing Facility
- Article 78 Proceeding Ensures Client's Enrollment as a Medicaid Provider
- Billing Victory for Health Care Provider
- Chapter 11 Proceedings for Full-Service Hospital
- Defense of Healthcare Organization in Class Action Lawsuit
- Department of Justice Mandated Self-Audits Resolved Favorably
- Development and Financing of Medical Office Building
- Development of a $300 Million Clinical Translational Research Center/Biosciences Incubator
- Development of a $375 Million Medical School
- Expansion of Health Center and Skilled Nursing Unit
- Favorable USPTO Ruling in Patent Infringement Case
- Hodgson Russ Wins CON Approval for Major Health Care System
- IPA Regulatory and Contracting Issue Advisement
- Multiparty Merger of Western New York Hospital Group
- Public Nursing Home Restructurings
- Real Estate Counsel to Buffalo Niagara Medical Campus
- Renegotiation of Hospital System Relationship on Behalf of Radiology Group
- Sale of Medical Office Complex
- Structuring a Joint Venture to Develop Innovative Model of Care Delivery on Behalf of Large Hospital System
- Successful Merger of Numerous Hospitals, Nursing Homes, Foundations & Subsidiaries
In the News
- WGRZ, September 15, 2022
- Buffalo Business First, September 14, 2022
- Buffalo Business First, January 29, 2021
- NYSBA, December 8, 2020
- April 23, 2020
- Albany Business Review, December 6, 2019
- New York Post, November 11, 2019
- Albany Business Review, June 15, 2018
- June 3, 2016
- Buffalo Law Journal, March 7, 2016
- Buffalo Business First, December 11, 2015
- Albany Business Review, November 6, 2015
- Buffalo Business First, August 25, 2015
- Buffalo Law Journal, July 27, 2015
- May 30, 2013
- September 19, 2012
- June 19, 2012
- June 11, 2012
- June 17, 2011
- February 16, 2011
- Health Care: Lots of Questions From ClientsBuffalo Law Journal, November 1, 2010
- July 2, 2010
- October 14, 2008
- July 9, 2008
Press Releases
- June 6, 2023
- September 16, 2022
- Hodgson Russ Press Release, August 19, 2022
- Hodgson Russ Press Release, June 2, 2022
- Hodgson Russ Press Release, November 15, 2021
- Hodgson Russ Press Release, May 26, 2021
- Hodgson Russ Press Release, April 24, 2020
- Hodgson Russ Press Release, March 24, 2020
- Press Release, May 1, 2019
- Press Release, June 12, 2017
- Press Release, November 18, 2015
- Press Release, June 15, 2015
Publications
- Hodgson Russ Healthcare Alert , September 7, 2023
- Hodgson Russ Home Care and Healthcare Alert, May 16, 2023
- February 7, 2023
- Hodgson Russ OSHA and Healthcare Alert, March 28, 2022
- Hodgson Russ Healthcare Alert, January 6, 2022
- Hodgson Russ Healthcare and Labor & Employment Alert, November 5, 2021
- Hodgson Russ Healthcare and Labor & Employment Alert, November 2, 2021
- Hodgson Russ Healthcare and Labor & Employment Alert, October 13, 2021
- Coronavirus Guidance Update - Healthcare, August 27, 2021
- Hodgson Russ Healthcare Alert, August 25, 2021
- Hodgson Russ OSHA Alert, June 15, 2021
- Hodgson Russ Cybersecurity and Privacy Alert, February 26, 2021
- Hodgson Russ Healthcare Alert, January 19, 2021
- Hodgson Russ Healthcare Alert, January 19, 2021
- Hodgson Russ Healthcare Alert, November 11, 2020
- American Health Law Association, September 18, 2020
- Hodgson Russ Healthcare and Cybersecurity & Privacy Alert, August 14, 2020
- Hodgson Russ Healthcare Alert, June 25, 2020
- Hodgson Russ Healthcare Alert, May 11, 2020
- Hodgson Russ Healthcare Alert, May 6, 2020
- Hodgson Russ Healthcare Alert, April 24, 2020
- Hodgson Russ Healthcare Alert, April 21, 2020
- Hodgson Russ Healthcare Alert, April 10, 2020
- Hodgson Russ Healthcare Alert, April 9, 2020
- Hodgson Russ Healthcare Alert, April 8, 2020
- Hodgson Russ Healthcare Alert, April 6, 2020
- Hodgson Russ Healthcare & OSHA Alert, April 2, 2020
- Hodgson Russ Healthcare Alert, March 31, 2020
- Hodgson Russ Healthcare Alert, March 24, 2020
- Hodgson Russ Healthcare Alert, March 20, 2020
- Hodgson Russ Healthcare Alert, March 18, 2020
- Hodgson Russ Healthcare Alert, March 9, 2020
- Hodgson Russ Healthcare Alert, November 6, 2019
- Hodgson Russ Healthcare Alert, November 6, 2019
- Hodgson Russ Healthcare Alert, November 6, 2019
- Health Law Alert, January 24, 2019
- May 14, 2018
- Health Care Alert, December 20, 2017
- Home Care Alert, November 15, 2017
- Home Care Alert, November 14, 2017
- Home Care Alert, November 3, 2017
- October 27, 2017
- Home Care Alert, August 11, 2017
- Buffalo Law Journal, August 25, 2016
- Wage & Hour Alert, December 29, 2015
- Health Alert, November 3, 2015
- Wage & Hour Alert, September 16, 2015
- Health Alert, July 17, 2015
- Hodgson Russ Newsletter, May 22, 2015
- Labor & Employment Alert, January 15, 2015
- New York Law Journal, November 10, 2014
- Labor & Employment Alert, August 26, 2013
- The Journal of Medical Practice Management, March/April 2012
- Health Alert, September 6, 2011
- Health Alert, June 20, 2011
- Health Alert, June 1, 2011
- Health Alert, February 28, 2011
- Health Alert, November 3, 2009
- August 21, 2009
- Health Alert, July 9, 2009
- American Health Lawyers Association, April 22, 2009
- Health Alert, March 27, 2009
- Health Law, March 17, 2009
- Dennis Barry’s Reimbursement Advisor, August 2008
- New York State Bar Association Health Law Journal, 2007
Presentations & Events
- Long Island Marriott, October 26, 2023
- Hodgson Russ, 140 Pearl Street, Buffalo, NY 14202, September 22, 2023
- Hodgson Russ, 140 Pearl Street, Buffalo, NY 14202, June 29, 2023
- Mariott Albany, Albany, New York, December 7, 2022
- November 11, 2022
- September 8, 2022
- October 29, 2020
- June 19, 2020
- May 27, 2020
- March 20, 2020
- March 17, 2020
- June 21, 2019
- May 8, 2019
- New York State Health Facilities Association, Telepsychiatry – Past the Tipping PointSeptember 5, 2018
- Greater New York Health Care Facilities Association, The Use of Electronic Medical Records in eDiscoveryUniondale, New York, June 21, 2018
- Saratoga Springs, NY, May 24, 2018
- Hodgson Russ LLP, NYC, June 20, 2017
- The Offices of Hodgson Russ LLP, 140 Pearl Street, Buffalo NY, October 6, 2016
- The Offices of Hodgson Russ LLP, 140 Pearl Street, Buffalo, NY, November 19, 2015
- Stark Law Do's and Don'ts: Best Practices for Physician Financial RelationshipsRochester Regional Healthcare Association and the Western New York Healthcare Association, Joint Compliance SeminarBatavia, NY, May 19, 2015
- New York, NY, October 10, 2012
- Buffalo, NY, July 29, 2009