The Tax & Benefits/Health Care team 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.

Our lawyers also serve as bond counsel, underwriters’ counsel, and borrowers’ counsel on billions of dollars of tax-exempt debt nationwide.

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 services for our clients.

Lawyers in our Tax-Exempt Health Care Organizations team 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 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.