Provider and Physician Groups
Counsel that delivers value and results to clinics and medical practices
Capabilities at a glance
- Attorneys with decades of experience representing health care clients, including independent clinics and networks of physician and non-physician practitioners.
- A nationally recognized health care practice with significant resources and a deep bench.
- A one-stop shop for individual practitioners and group practices, covering the gamut of legal issues, such as health care regulatory law, labor and employment, intellectual property, real estate, tax law, tax exemption, immigration and insurance regulation.
- Excellent connections with state and federal regulators, including licensing boards and regulatory agencies.
Shared purpose with clients on health law
While we have a significant practice representing hospitals and health care systems, we also have deep experience representing individual providers and group practices. We understand the full gamut of laws that confront medical practitioners, and we are familiar with the legal landscape as well as the business side of things. This allows us to offer clear practical and strategic advice that fits squarely within the parameters of applicable law. We have helped our provider clients negotiate the quickly changing health care landscape and the constant new regulations emerging from both state and federal lawmakers. For many of our health care provider clients, we serve in a role similar to in-house counsel. We help our clients navigate the laws that govern arrangements between hospitals and physicians and other aspects of physician practice, and we have the tools and experience to keep our clients compliant on the front end.
Experience-led advice for health care providers and physician groups
Few law firms of any size have the varied experience, resources and in-depth legal and health care knowledge found at Quarles. Many of our attorneys have health care industry experience as well as technical legal skills in the area. Our clients often seek advice in the following areas:
- Medical practice formation, sale, dissolution and management
- Accomplishing licensure and managing licensing board investigations and concerns
- Scope of practice, collaboration and supervision of non-physician practitioners
- Patient care-related legal and strategic issues
- Patient informed consent
- Medical staff membership and structure with regard to hospital affiliations
- Contracting within legal parameters
- Employment law
- Regulatory compliance
- Health care information and technology
- Privacy and data breach
- Health care reimbursement
- Intellectual property (IP)
- Medical staff and peer review
- Health care transactions
- Pharmacy and DEA
- Litigation
- Government variances
- Internal audits
- Provider Reimbursement Review Board (PRRB)
Experience
- Representing practitioners in becoming licensed or negotiating licensing board actions.
- Negotiating vendor contracts such as electronic medical records and practice management.
- Assisting with mergers and acquisitions (M&A).
- Providing counsel on collaboration and supervision requirements for non-physician practitioners and drafting required agreements.
- Assisting with hospital medical staff issues.
- Service contracting with other health care facilities.
- Analyzing contemplated arrangements to ensure compliance with health care regulations, including the Stark law, the Anti-Kickback Statute and the False Claims Act.
- Assisting with governmental inquiries, investigations and lawsuits.
- Assisting with disruptive or noncompliant patient relationships.
- Reviewing and drafting compliance plans and policies.
- Assisting with billing systems and audits to ensure compliance.
- Representing providers in disputes relating to reimbursement, including with the PRRB.
Successes
- We assisted a physician assistant who was the subject of multiple reports by an angry ex-patient in successfully getting all such reports dismissed and deterring the patient from filing future unwarranted complaints.
- We negotiated a complicated affiliation agreement for a sports medicine physician with a hospital that took into account his value to the community, in addition to straight production.
News & Insights
Provider and Physician Groups Focus Areas
Behavioral Health
We advise and represent providers, integrated behavioral health clinics, substance abuse clinics, outpatient and residential treatment centers, and health plans to navigate this ever-changing space. We understand the care and commitment needed by our clients to provide behavioral health services, and we help them manage risk while reaching their business goals.
We have vast experience in the behavioral health profession, including representing providers practicing in the mental illness, substance abuse and developmental disability industries. These growing and constantly evolving industries present a complex regulatory environment for businesses operating in this space. We provide a broad and full range of behavioral health legal services, including regulatory and compliance advice, licensing, reimbursement and enrollment issues, policy and procedure evaluation and creation, corporate compliance, privacy and security, internal and federal investigations, mergers and acquisitions, telehealth, pharmacy, civil litigation and more.
Please contact Nick Meza, Kirti Reddy or Jaya White for more information.
Oncology Care Providers
Our team supports oncology providers with all aspects of their practices so they can deliver critical cancer care. This includes reviewing clinical trials and other research opportunities, assisting with in-office administration and in-office dispensing operations, reviewing physician compensation arrangements, standing up imaging and laboratory services, acquiring and selling practice sites and assets, and advising on other practice management issues. From independent physician groups to multisite/multistate practices to cancer care centers, our attorneys often serve as outside general counsel to oncology providers, leveraging our bench of attorneys in other practice areas to address labor and employment issues, real estate matters, occupational and environmental hazards (particularly with respect to chemotherapy and waste), litigation and corporate governance issues.
Ophthalmology and Optometry
Quarles attorneys represent optometry and ophthalmology practices, providing regulatory and corporate legal advice to integrated vision practices. Our team has extensive experience representing professionals and practices before state optometry and dispensing optician boards. We guide businesses through varied and nuanced state laws governing practice operations, licensing, fraud, waste and abuse, privacy, reimbursement and the corporate practice of medicine. We understand the unique delivery models in the constantly evolving eyecare space and are able to provide practical, business-centric advice on a local or national level.
OSHA and Workplace Safety
Regarding workplace safety, our clients rely on the comprehensive and real-world practical experience that our attorneys bring to this vital area of law. Our attorneys work with companies to develop proactive, effective and compliant solutions that prioritize employee health and safety and minimize adverse regulatory actions. When federal and state workplace safety regulators conduct inspections, Quarles is ready to respond. We regularly represent clients during inspections and in follow-up dealings with the Occupational Safety and Health Administration (OSHA), and we will help you effectively respond quickly to what can be fast-moving situations. Our team is well prepared to defend OSHA citations. Our solutions will always seek to minimize penalties and negative classifications imposed on our clients, satisfy regulators’ desire for abatement and serve all parties’ interests in promoting workplace safety.
Physician Dispensing
We understand the complexities and unique issues clients face on a national basis regarding physician dispensing programs. We work with pharmacists, pharmacies, physician and specialty physician practices, and pharmacy benefits managers (PBM) to support their physician dispensing programs throughout the country. Our extensive experience includes analysis of state laws governing in-office dispensing (IOD) operations and innovative delivery models; development of 50-state surveys and physician compounding and admixture activities; facilitating processes with state regulatory boards; development and analysis of legislation and regulation governing IOD models and reimbursement mechanisms; advising on the integration of pharmacy and physician practice operations and personnel; counseling on the fraud, waste and abuse implications of IOD models; strategic implementation of alternative models; assessing and implementing activities needed for compliance with DEA and state-controlled substance acts governing controlled substance dispensing; and development of specialty drug programs and IOD operations.