Healthcare Transactions
- A growth equity firm in its acquisition of Invoice Cloud, a-payment platform that allows customers, including healthcare providers, to receive, access and pay bills electronically in a self-service environment.
- Invoice Cloud in connection with its acquisition of SimplePractice, a behavioral health electronic health record company.
- William Blair as underwriter in connection with a note offering by Covenant Surgical Partners, a privately-held owner and operator of ambulatory surgery centers, anatomic pathology laboratories, anesthesia entities and physician practices.
- Henry Schein, Inc. (Nasdaq: HSIC), the world's largest provider of healthcare products and services to office-based dental, animal health and medical practitioners., in connection with a joint venture with Clinician's Choice Dental Products, Inc., a manufacturer of dental products and provider of continuing dental education.
- Henry Schein Practice Solutions Inc. (HSPS), the practice solutions business of Henry Schein, Inc., in connection with an exclusive distribution agreement with Simplifeye. Simplifeye is an application that integrates with electronic health records systems to allow dental teams to access patient information from an Apple Watch or iPhone.
- HSPS in connection with a joint venture with Brightsquid, a provider of secure e-mail solutions.
- Fifth Street Finance Corp. in connection with its acquisition of Healthcare Finance Group, LLC (HFG). HFG is a specialty lender providing asset-based lending and term loan products to the healthcare industry.
- Ascension Ventures in connection with its investment in Zipnosis. Zipnosis offers a telemedicine platform that enables health systems to launch their own branded telemedicine service lines staffed with their own clinicians.
- Trident Capital, Inc. in connection with its investment in Advanced ICU Care, the nation's largest independent provider of tele-ICU programs.
- Texas Pacific Group (TPG), and its portfolio company, Surgical Care Affiliates, in connection with the acquisition of 137 ambulatory surgery centers from HealthSouth Corporation (NYSE: HLS).
- Community Health Systems, Inc. (NYSE: CYH) in its acquisition of Triad Hospitals Inc. (NYSE: TRI).
Fraud and Abuse
- On behalf of the Hospital for Special Surgery (HSS), defeated an effort by two medical device companies to avoid paying millions in royalties based on the claim that they were prohibited from making the payments under the terms of a deferred prosecution agreement that one of the companies had entered into to avoid prosecution for alleged violations of the Anti-Kickback Statute. The case was resolved after the court issued an order indicating that it would grant HSS summary judgment in a forthcoming opinion. N.Y. Soc. for the Relief of the Ruptured and Crippled, Maintaining the Hosp. for Special Surgery v. Wright Med. Tech., Inc., No. 15 Civ. 2871 (S.D.N.Y.).
- Following a lengthy investigation, obtained the voluntary dismissal, with the government's consent, of a qui tam action against a highly ranked academic medical center alleging that it improperly admitted patients for surgical procedures that could have been performed on an outpatient basis.
- Represented defendants Continuum Health Partners, Beth Israel Medical Center, and St. Luke's Roosevelt Hospital Center in a nationally watched case involving the first use of new provisions under the False Claims Act and Affordable Care Act creating liability for the retention of Medicare and Medicaid overpayments. United States ex rel. Kane v. Continuum Health Partners, Inc., No. 11 Civ. 2325 (S.D.N.Y).
- After convincing the government not to intervene, obtained dismissal of a qui tam action seeking billions in civil penalties and damages against HSS alleging, among other things, that it violated the False Claims Act, the Anti-Kickback Statute, and the Stark Law by paying physicians at rates that exceeded fair market value. United States ex rel. Corporate Compliance Assoc. v. N.Y. Soc. for the Relief of the Ruptured and Crippled, Maintaining the Hosp. for Special Surgery, 2014 WL 3905742 (S.D.N.Y. 2014).
- Represented a safety net hospital in an action under the False Claims Act alleging that it exploited a flaw in the reimbursement methodology for extremely costly cases known as "outliers" to fraudulently increase its Medicare reimbursement for such cases. The case was resolved through a settlement at less than 5% of the government's initial demand.
- After convincing the government not to intervene, obtained dismissal of a qui tam action against Maimonides Medical Center alleging Maimonides engaged in a decade-long conspiracy to defraud the Medicare program of tens of millions of dollars. United States ex rel. Pervez v. Maimonides Med. Ctr., 2010 WL 890236 (S.D.N.Y. 2010).
- After convincing the government not to intervene, obtained dismissal of separate federal and state qui tam actions against a major academic medical center and several former executives seeking billions in penalties and damages based on the submission of allegedly fraudulent cost reports. United States ex rel. Colucci v. Beth Israel Med. Ctr., 785 F. Supp. 2d 303 (S.D.N.Y. 2011); New York ex rel. Colucci v. Beth Israel Med. Ctr., N.Y. Sup. Ct. No. 112059/07.
HIPAA and Data Privacy and Security
- Serve as outside counsel on HIPAA and healthcare privacy and data security for a number of healthcare providers, health plans and technology companies.
- Advised a large, publicly traded medical supply company with a widely used electronic health record product on HIPAA compliance.
- Advise a variety of healthcare providers regarding the exchange of healthcare information in connection with coordinated care programs.
- Advised HSS on the implementation of an electronic health records system and obtaining reimbursement under a Medicare incentive program for the meaningful use of electronic health records.
- Counsel a variety of healthcare providers, health IT companies, and other business associates in regard to data breaches and security incidents.
Reimbursement Litigation
- In a case of first impression in the New York, convinced an appellate court to recognize a private right of action for healthcare providers under New York's Prompt Payment Law. Maimonides Med. Ctr. v. First United American Life Ins. Co., 116 A.D.3d 207 (2d Dep't 2014).
- Obtained a favorable decision valued at $18 million for a health system in a dispute with one of the country's largest health insurers following a one-week hearing before a panel of arbitrators.
- Recovered the full amount owed plus interest and legal fees on behalf of a surgical group after an insurer improperly recouped payments made to the practice for emergency services.