Jones Day lawyers counsel clients on how to structure transactions, arrangements, and conduct operations to comply with the broad array of complex federal and state laws and regulations governing the health care industry.
Our lawyers advise clients on matters involving federal and state fraud and abuse laws, including the federal Anti-Kickback Statute and the Stark Law; Medicare and Medicaid reimbursement and payment rules, transplant program accreditation, clinical research, HIPAA, and EMTALA, among others. We advise clients on self-reporting overpayments and regulatory violations to government agencies, making refunds to fiscal intermediaries and carriers, and submitting self-disclosures under the HHS OIG Self-Disclosure Protocol.
We also have a tax-exempt organizations team that focuses on significant tax compliance matters and controversies for nonprofit hospitals and their affiliates, with an emphasis on structuring and reporting of complex transactions, avoiding unrelated business income, and defending major IRS audits (including excess benefit allegations) and state property tax exemption challenges.
In order to avoid enforcement actions, Jones Day lawyers assist clients in developing and implementing compliance programs and policies and practices designed to promote compliance with the laws and regulations governing health care entities.
Tax-exempt Health Care Organizations
Many of our tax-exempt health care organization lawyers also have broader tax, health care regulatory, transactional, or litigation experience. This multi-disciplinary background enables our lawyers to better understand the overall business needs of the client and competing legal concerns. Their broad experience also allows the group to provide more efficient service for our clients. These lawyers have extensive experience in structuring corporate mergers, acquisitions, reorganizations, joint ventures, joint operating agreements, integrated delivery systems, clinics, HMOs, and PPOs. For example, our lawyers obtained the first ever IRS ruling approving a nonprofit hospital joint operating agreement (PLR 9609012), and the first hybrid JOA/Merger ruling (PLR 199944046).
Our lawyers have represented several nonprofit clients in a variety of tax controversies, including some of the largest exempt organization audits ever conducted. We have both negotiated successful settlements and successfully challenged the IRS in court on behalf of tax-exempt organizations facing substantial assessments. We also have defended multiple hospitals against class actions brought by the uninsured, challenges to property tax exemption, and responded to multiple federal government inquiries regarding charity care practices.
We also have substantial experience in performing audits on behalf of clients to assess current compliance with applicable laws, regulations, and reporting requirements, including disclosures on the redesigned Form 990, assessment of uncertain tax positions under FASB’s Financial Interpretation No. 48 (FIN 48), and the appropriate structuring of executive compensation and physician compensation programs to avoid excess benefits.
Our tax attorneys have served as Vice Chairs and Chair of the American Health Lawyers Association’s Tax & Finance Practice Group and also have co-authored the first comprehensive treatise on state and federal charity care standards for nonprofit hospitals.
Health Information Technology, Privacy, and Security
In the health information technology, privacy and security area, Jones Day's health care clients look to us to help address and manage the competing demands of personal privacy and the permissible use of health information; a conflict intensified by the increasing use of electronically maintained health data.
Our lawyers advise clients across the spectrum of legal issues arising from the use and maintenance of patient information and related activities, including acquiring and implementing health information technology (such as electronic medical records and personal health records), monitoring and ensuring compliance with regulatory issues (e.g., HIPAA, HITECH), addressing security breaches, safeguarding health information, participating in health information exchanges and telemedicine activities, and negotiating software license agreements and outsourcing arrangements. Our lawyers’ combination of legal experience and knowledge of the health care and information technology industries makes Jones Day well qualified to recognize our clients’ needs and provide those clients with effective, business-oriented advice in approaching these complex matters.
Transplant Program Accreditation
Jones Day also advises solid organ transplant centers across the United States on all matters concerning operations, UNOS membership (including disciplinary proceedings) and CMS certification (including proposed de-certifications).