Roger A. Cohen is a partner in Goodwin’s nationally recognized Life Sciences Practice. He counsels healthcare services, life sciences, and healthcare IT clients concerning compliance with the myriad laws and regulations governing the delivery of healthcare services such as the Anti-Kickback Statute, the Physician Self-Referral Law (the Stark Law), the False Claims Act, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Medicare and Medicaid rules and regulations, and laws governing reimbursement, licensure and certification.

Mr. Cohen’s experience also includes extensive work on healthcare transactions. He has represented clients in acquisitions and financings involving a wide variety of healthcare providers including hospitals, ambulatory surgery centers, physician groups, skilled nursing facilities, rehabilitation and physical therapy facilities, behavioral health and substance abuse treatment providers, dental clinics, home healthcare providers, clinical laboratories, pharmacies, and care management companies, among others. Mr. Cohen also has deep experience assisting clients in transactions involving and providing counsel to health IT companies such as telemedicine providers and electronic health record, mobile health (mHealth), and digital health companies.

In addition to his transactional work, Mr. Cohen has a long track record of successfully representing healthcare and life science clients in government investigations and litigation. He has represented clients in many high-stakes healthcare fraud investigations, frequently convincing the government not to pursue enforcement action against his clients and obtaining dismissals in a number of actions that have proceeded to litigation. Mr. Cohen also frequently assists clients with internal investigations related to fraud and abuse and advises clients concerning self-disclosures.

Mr. Cohen also represents clients in managed care reimbursement disputes and litigation. Among other matters, in a case that received significant attention in the legal press, he established new precedent in New York, convincing an appellate court to recognize an implied private right of action for health care providers under New York’s Prompt Payment Law. 

Mr. Cohen has been recognized for his expertise by a number of industry publications. In 2017, The Legal 500 noted that Mr. Cohen is “a fantastic all-round, multi-faceted healthcare lawyer” and listed him as one of only two “Next Generation Lawyers” for health care service providers in the United States. Law360 selected Mr. Cohen as one of five rising stars in the nation in healthcare law in 2014. New York Super Lawyers has recognized Mr. Cohen as a rising star in healthcare law annually since 2013.

Mr. Cohen is a frequent speaker at healthcare industry events and regularly publishes articles about healthcare law. He is also the editor of a chapter covering healthcare privacy in a prominent privacy law treatise and served on the editorial board of the American Health Lawyers Association’s Corporate Practice of Medicine: A Fifty State Survey

Prior to joining Goodwin in 2017, Mr. Cohen was a senior counsel at Proskauer Rose.

Areas of Practice
TÄTIGKEITSFELDER
业务范围

Experience

ERFAHRUNG

工作经历

Healthcare Transactions

  • Frazier Healthcare Partners in its acquisition of TCGRx, a supplier of pharmacy packaging and automation solutions and related consumables.
  • Frazier Healthcare Partners in its acquisition of a minority stake in Island Medical Management, LLC, a provider of physician management and staffing services to more than 80 hospitals.
  • Great Hill Partners LLC in its buyout of Quantum Health, Inc., a technology-enabled healthcare services company that offers coordinated health and care programs for companies who operate self-insured employee benefit plans.
  • Great Hill Partners LLC in its acquisition of PartsSource, Inc., a provider of medical replacement parts and related procurement services for healthcare providers.
  • Better Care, Incorporated, the owner and operator of skilled nursing facilities in northern California, in the sale of all of its outstanding stock to Atlantic Ocean Holdings, Inc.
  • Primus Capital in its acquisition of Healthcare Bluebook, Inc. a provider of online tools to enable consumers to look up the price for medical procedures, diagnostic tests, medications and other services.
  • Primus Capital in its acquisition of Complete Holdings Group, Inc. (a/k/a EnableComp), a leading technology-enabled healthcare services company that provides workers’ compensation revenue-recovery services to the healthcare providers.
  • 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

  • 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 the plaintiff hospital summary judgment.  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 aqui 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 the defendant hospitals 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 the hospital defendant 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 an academic medical center alleging that it 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 an 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, 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 the American Arbitration Association.
  • 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.

Recognition

  • The Legal 500 “Next Generation Lawyers,” 2017
  • Law360 Rising Star 2014
  • New York Super Lawyers “Rising Stars,” 2013-2016

In The News

MELDUNGEN

在新闻中

Credentials

WERDEGANG

专业资格

Education

J.D.
Fordham University School of Law
(cum laude)
B.G.S.
University of Michigan

Admissions

Bar

New York

Courts

U.S. District Court for the Southern District of New York
U.S. Court of Appeals for the Second Circuit
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Our clients rely on us for world-class advisory services, counsel on complex transactional work and high-stakes litigation. Specializing in matters involving the financial, life sciences, private equity, real estate, and technology industries, we use a collaborative, cross-disciplinary approach to resolve our clients’ most challenging issues. To find out more, please contact us.
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