Whiteford's Healthcare Law group advises healthcare entities (including managed care companies, hospitals, medical groups, e-health companies, insurance companies, pharmacy benefit managers, vision centers, practice management companies, ambulatory centers and other facilities) with respect to legal issues specific to the healthcare industry. Our Healthcare Law Group draws upon the diverse talents of attorneys firm-wide with experience in virtually every aspect of legal practice.
The Healthcare Law Group provides counsel on all aspects of health law ranging from fraud and abuse and corporate practice of medicine to government regulation and privacy. We counsel clients on HIPAA compliance as well as federal and state laws regulating managed care, Medicare and Medicaid. The Group also counsels and represents clients on matters related to compliance with anti-kickback statutes, self-referral legislation (the "Stark Law") and defending against False Claims Act actions. Our attorneys advise healthcare clients with respect to antitrust issues inherent in such matters as preferred provider organizations, joint venture arrangements and mergers and acquisitions.
In addition, the Healthcare Law Group provides guidance to insurance carriers and employers on health benefit plans. Our healthcare attorneys work closely with our Employee Benefits practice group to assist in the design of managed care mechanisms for employers and negotiations with direct contracting providers. Attorneys in the Healthcare Law Group routinely advise with respect to the laws relating to tax-exempt organizations and represent both tax-exempt organizations and for profit healthcare business in all types of business transactions, including, without limitation, joint ventures, mergers, corporate reorganizations, sales of business assets, stock or membership interests and numerous other types of transactions relating to or arising from the integrated delivery systems used to deliver healthcare services to the public.
Healthcare Litigation
Our Healthcare Litigation attorneys provide a wide array of litigation and consultative services to hospitals, pharmacy networks, physicians, dentists, HMOs, physician practice groups, nurses, mental health counselors, and nursing homes. These attorneys have defended practitioners, hospitals and healthcare groups in lawsuits before the Maryland Health Claims Arbitration Office and the federal and state trial courts throughout Maryland and the District of Columbia. The cases we are able to handle involve all healthcare specialties, including obstetrics and gynecology, neurosurgery, pediatrics, cardiothoracic surgery, transplant surgery, psychiatry, ophthalmology, oncology, radiology, urology, pathology, oral surgery, periodontics, prosthodontics, nursing, geriatric care, and physical therapy.
In addition, we provide risk management counseling services to clients. These services include lectures, mock trials, and other presentations to insurance carriers and individual insureds as well as to hospital risk managers and departments and hospital medical staffs.
Our attorneys also represent physicians, nurses, and other healthcare professionals in credentialing disputes and investigations and disciplinary actions before specialty boards. Our attorneys often are asked to assist physician groups and hospitals in formulating policies regarding retention and disclosure of medical records and other office practices that affect the potential risk/liability of the provider.
The IRS has recently been urging healthcare entities, particularly those involving physicians and private investors, to seek private letter rulings (PLRs) to clarify the tax implications of their ownership structures. This encouragement comes in light of the complexities and ambiguities surrounding the "friendly doctor" or "friendly PC" models, where a physician-owned professional corporation (PC) is managed by a separate management service organization (MSO).
In 2024, Stark Law enforcement remains a critical focus for healthcare providers and regulatory bodies, with a continued focus on excessive compensation and productivity bonuses. Compliance with Stark Law is essential to avoid significant penalties, including repayment obligations, civil monetary penalties, and potential exclusion from federal healthcare programs.
The California Department of Public Health (CDPH) issued a letter on September 6, 2024, to all general acute care hospitals clarifying the scope of practice for Certified Registered Nurse Anesthetists (CRNAs) following confusion and issues at hospitals in Modesto, California earlier this year.
The American Academy of Emergency Medicine Physician Group (AAEM-PG) recently settled a lawsuit in United States District Court for the Northern District of California against Envision Healthcare and Envision Physician Services, accusing them of violating the corporate practice of medicine (CPOM) laws in California.[1] The lawsuit alleged the “friendly physician” model used by Envision to control medical practices through management services agreements interfered with the medical judgment and autonomy of the medical entities Envision served. The model is commonly used in physician practice transactions with private equity investors.[2] The suit was unusual in that it was a private entity, not a government entity, requesting relief and asked the court to find models and those alike illegal in California.
The Department of Health and Human Services (HHS), in conjunction with the Centers for Medicare and Medicaid Services (CMS), is striving to alleviate the financial strain of medication costs on the elderly and disabled populations who rely on Medicare with the Medicare Prescription Drug Payment Plan. CMS has released final part two guidance for CY 2025 on July 16, 2024, to prepare stakeholders for its implementation.
For companies whose operations are subject to strict federal regulations – and particularly those that are facing or may be facing enforcement actions – take note. The U.S. Supreme Court may have just leveled the playing field. On Friday, June 28, 2024, the Supreme Court overturned a long-standing legal precedent that instructed courts to defer to federal agencies’ interpretations of ambiguous laws they administer. Instead, federal laws will be interpreted by the courts. Federal agencies will need to prove their cases, including enforcement actions where an arguably ambiguous statute is at issue. This is good news for businesses in the U.S.
The article provides an overview of the CMS Interoperability and Prior Authorization final rule and its implications for different types of providers. It summarizes the main requirements and deadlines for the rule, which aims to improve the efficiency and transparency of healthcare delivery by requiring the use of standardized APIs for data exchange among payers, providers, and patients.
The Federal Trade Commission (FTC) issued a final rule to amend its Health Breach Notification Rule (HBN Rule). The HBN Rule requires certain entities that handle unsecured personally identifiable health data to notify individuals, the FTC, and sometimes, the media of a breach of security.
On May 21, the Centers for Medicare and Medicaid Services (CMS) announced a new option on CMS.gov to allow individuals to more easily file an Emergency Medical Treatment and Labor Act (EMTALA) complaint.
On May 1, 2024, the U.S. Department of Health and Human Services (HHS), through its Office for Civil Rights (OCR), finalized a rule that prohibits discrimination on the basis of disability. This rule (“Final Rule”), titled Discrimination on the Basis of Disability in Health and Human Service Programs or Activities, more explicitly and specifically provides protections for people under Section 504 of the Rehabilitation Act (Section 504).
Even after a large amount of industry pushback, CMS issued the final rule for minimum staffing requirements and institutional payment transparency for long-term care (LTC) facilities. While stakeholders have indicated that the rule could put more pressure on current staff and lead to further workforce burnout, CMS insists the regulations are needed to ensure safety of the nation’s vulnerable populations.
Even after a large amount of industry pushback, CMS issued the final rule for minimum staffing requirements and institutional payment transparency for long-term care (LTC) facilities.
Centers for Medicare & Medicaid Service (CMS) revised hospital interpretive guidance in the State Operations Manual, Appendix A-Hospitals on April 1, 2024 in response to media stories of nation’s teaching hospitals and medical schools repeatedly performing sensitive examinations while under anesthesia without informed consent. Highlighted sensitive exams include but are not limited to pelvic, breast, prostate, and rectal examinations. The new guidance is effective immediately.
Use of algorithms and artificial intelligence (AI) in prior authorization and utilization management is facing growing criticism and litigation. Notable lawsuits include alleged automatic authorization denials for tests that don’t match plan-determined diagnosis or that denied payment for post-acute care that exceed AI-predicted lengths of stays. The criticism has been that these decisions are not based on proper criteria or made in compliance with regulations.
The U.S. Attorney’s Office for the Eastern District of Pennsylvania recently announced that it had reached a settlement with Cigna Group (Cigna) to resolve allegations that Cigna had violated the False Claims Act.
In its recent ruling in U.S. v. Hathaway, the Sixth Circuit Court of Appeals provided additional authority that will be welcome to parties defending False Claims Act (“FCA”) matters based on the Anti-Kickback Statute (“AKS”).
The Court addressed two key points. First, it held that a violation of the AKS must be based on the payment of money or actual transfer of something of value. Second, it held that to prove a violation of the FCA, a relator must demonstrate but-for causation. In doing so, the Sixth Circuit has added another defendant-friendly ruling to the existing, and perhaps growing, circuit split.
Each year the Maryland Legislature enacts a number of laws which impact, in varying degrees, on the personal and business lives of people living in or doing business in the State of Maryland. The General Assembly adjourned on April 7, 2003, and the Session actively concluded when the Governor enacted legislation into State law during four separate signing ceremonies on April 8, April 22, May 13 and May 22, 2003.
The General Assembly adjourned on April 7, 2003 and the Session actively concluded when the Governor enacted legislation into State law during four separate signing ceremonies on April 8, April 22, May 13 and May 22. This year, as has been the case for the past several years, the Maryland Legislature was particularly active in the health care arena. The Legislature passed, and the Governor signed, a substantial number of important health care laws.
Health Occupations – Maryland Optometry Act – Replacement Contact Lenses – Clarifications and Modifications (SB 387) (10/01/03) - Prohibits a person from knowingly selling or dispensing contact lenses or replacement contact lenses without a valid and unexpired prescription or replacement contact lens prescription. A person who violates any provision shall be guilty of a misdemeanor and, on conviction, subject to a fine not exceeding $1,000.
Each year the Maryland Legislature enacts a number of laws which impact in various degrees on the personal and business lives of people living in or doing business in the State of Maryland. The General Assembly adjourned on April 8, 2002, and the Session actively concluded when the Governor enacted legislation into State law during four separate signing ceremonies on April 9, April 25, May 6 and May 16.
This webinar highlights trending obstacles in healthcare recruitment, examines the legal considerations for mechanisms used to entice recruits, and provides practical tips for compliance with specific healthcare and employment laws.
Whiteford is pleased to announce that “Best Law Firms” has awarded the firm exemplary rankings for 2025. Twenty-two of the firm’s practices are ranked at the national level, and the firm’s Bankruptcy, Construction and Labor & Employment litigation practices have been recognized with national Tier 1 rankings.
Whiteford is pleased to announce that Chambers and Partners has once again ranked the firm highly in its 2024 list of leading firms and business lawyers.
87 lawyers from Whiteford, Taylor & Preston have been selected by their peers for inclusion in The Best Lawyers in America® 2024 (copyright 2023 by Woodward/White, Inc., of Aiken S.C.). New practice areas of recognition include CleanTech Law and Entertainment and Sports Law. The lawyers selected are based in the firm’s Delaware, Maryland, Pennsylvania, Virginia and Washington offices. Client comments are posted on the Best Lawyers website, at bestlawfirms.com.
Whiteford is pleased to announce that Chambers and Partners has once again ranked the firm highly in its 2023 list of leading firms and business lawyers.
Whiteford, Taylor and Preston is pleased to announce that U.S. News and World Report - Best Lawyers ® “Best Law Firms” has awarded the firm exemplary rankings for 2023.
Whiteford, Taylor & Preston is pleased to announce that Chambers and Partners has once again ranked the firm highly in its 2022 list of leading firms and business lawyers. This year’s recognition includes 29 attorneys in 14 practice areas at the National and State level.
Whiteford, Taylor and Preston is pleased to announce that U.S. News and World Report - Best Lawyers ® “Best Law Firms” has awarded the firm exemplary rankings for 2022. Twenty-one of the firm’s practices are ranked at the national level, and the firm’s bankruptcy and Construction Litigation practices have been recognized with national Tier 1 rankings. At the state level, new recognitions include Admiralty & Maritime Law, Nonprofit/Charities Law, Patent Law and Privacy and Data Security Law.
A record 75 lawyers from Whiteford, Taylor & Preston have been selected by their peers for inclusion in The Best Lawyers in America® 2022 (copyright 2021 by Woodward/White, Inc., of Aiken S.C.). The lawyers selected are based in the firm’s Delaware, Maryland, Pennsylvania, Virginia and Washington offices. Client comments are posted on the U.S. News & Best Lawyers web site, at bestlawfirms.com.
Whiteford, Taylor & Preston is pleased to announce that Chambers and Partners has once again ranked the firm highly in its 2021 list of leading firms and business lawyers. This year’s recognition includes 25 attorneys in 11 practice areas in 3 states and the District of Columbia.
A record 71 lawyers from Whiteford, Taylor & Preston have been selected by their peers for inclusion in The Best Lawyers in America® 2021 (copyright 2020 by Woodward/White, Inc., of Aiken S.C.). The lawyers selected are based in the firm’s Delaware, Maryland, Pennsylvania, Virginia and Washington offices. Client comments are posted on the U.S. News & Best Lawyers web site, at bestlawfirms.com.
Whiteford, Taylor & Preston is pleased to announce that Chambers and Partners has once again ranked the firm highly in its 2020 list of leading firms and business lawyers. This year’s recognition includes 23 attorneys in 10 practice areas in 3 states and the District of Columbia.
Whiteford, Taylor and Preston is pleased to announce that U.S. News and World Report - Best Lawyers ® “Best Law Firms” has awarded the firm exemplary rankings for 2020. Twenty of the firm’s practices are ranked at the national level, including two bankruptcy practices with national Tier 1 rankings. At the state level, an additional forty-two practices have been ranked in Maryland, Washington, D.C., and VA.
64 lawyers from Whiteford, Taylor & Preston have been selected by their peers for inclusion in The Best Lawyers in America® 2020. The lawyers selected are based in the firm’s Delaware, Maryland, Pennsylvania, Virginia and Washington offices. Client comments are posted on the U.S. News & Best Lawyers web site, at bestlawfirms.com.
Whiteford, Taylor & Preston is pleased to announce that Chambers and Partners has once again ranked the firm highly in its 2019 list of leading firms and business lawyers.
Whiteford, Taylor & Preston is pleased to announce that U.S. News and World Report - Best Lawyers ® “Best Law Firms” has awarded the firm exemplary rankings for 2019. Eighteen of the firm’s practices are ranked at the national level, including two practices with national Tier 1 rankings: Litigation and Bankruptcy. At the state level, an additional forty-six practices have been ranked in Maryland, Washington, D.C., and VA.
Whiteford, Taylor & Preston is pleased to announce that Chambers and Partners has once again ranked the firm highly in its 2018 list of leading firms and business lawyers. This year’s recognition includes 29 attorneys in a record 12 practice areas in 4 states, the District of Columbia and Afghanistan.
Baltimore – Whiteford, Taylor & Preston is pleased to announce that U.S. News and World Report - Best Lawyers ® “Best Law Firms” has awarded the firm exemplary rankings for 2018. Nineteen of the firm’s practices are ranked at the national level, including three practices with national Tier 1 rankings: Litigation, Bankruptcy and Real Estate. At the state level, an additional fifty practices have been ranked in Maryland, Washington, D.C., and VA.
Whiteford, Taylor & Preston is pleased to announce that Chambers and Partners has once again ranked the firm highly in its 2017 list of leading firms and business lawyers. This year’s recognition includes a record 29 attorneys in 4 states, the District of Columbia and Afghanistan.
Whiteford Taylor & Preston announced today that prominent Maryland health care attorney Sigrid C. Haines has joined the firm as a partner in its Columbia and Baltimore offices. With decades of experience in health care and elder law, Ms. Haines is experienced representing hospitals, medical and health-related foundations, health care systems, nursing homes, home health agencies, physicians and pharmacies.
Whiteford, Taylor & Preston is pleased to announce that 41 of its attorneys are listed among the 2017 Super Lawyers and Rising Stars in Maryland and Kentucky joining the sixteen who were listed earlier this year in Delaware, D.C., Pennsylvania and Virginia.
Whiteford, Taylor & Preston is pleased to announce that, in addition to ranking the firm highly in its 2016 list of Maryland’s leading firms and business lawyers, Chambers and Partners have added new Whiteford lawyers in Maryland and Delaware.
The practice group rankings are based on the high rankings of 21 individual lawyers.
Fifty-nine lawyers from Whiteford, Taylor & Preston have been selected by their peers for inclusion in The Best Lawyers in America® 2016 (copyright 2015 by Woodward/White, Inc., of Aiken S.C.). The lawyers selected are based in the firm’s Maryland, Washington and Virginia offices.
Whiteford Taylor & Preston LLP is very gratified to announce that the firm has once again received exemplary ratings in the fifth annual U.S. News & World Report rankings of law firms.
Whiteford Taylor & Preston LLP is very gratified to announce that the firm has received exemplary ratings in the second annual U.S. News & World Report rankings of law firms. In Maryland, WTP was rated highly in 34 practice areas, more than any other firm in the state.
