Specialty Health Care Providers

The move toward highly specialized, disease or service-specific settings for the delivery of health care, whether inpatient or outpatient, is being driven both by technological breakthroughs and favorable reimbursement treatment of such providers. In addition, such specialty providers may offer unique opportunities for increased physician involvement in administrative and clinical decision making. Each type of specialty health care provider raises unique legal, financial and operational issues, whether it is licensing, physician ownership, or simply structuring the arrangement to ensure appropriate reimbursement.

Representative Matters

Dialysis Providers

Baker Donelson currently represents two of the largest national dialysis providers as operations and health care regulatory counsel.

In the last three years, Health Law Department attorneys have assisted clients in acquiring 60 dialysis clinics, the developing de novo 45 clinics and structuring ten joint ventures for both acquisition and de novo development of clinics.

Ambulatory Surgery Centers

Baker Donelson has represented hospitals, physicians and proprietary organizations in developing and/or acquiring both general and specialty ambulatory surgery centers (ASCs), including women's health, general surgery, ophthalmology and urology surgery centers. Such representation has included: Structuring the transaction; developing contractual relationships for ASCs; addressing state and federal regulatory issues, CON, and state and federal securities issues; syndication of interests in ASCs to potential investors; obtaining financing for ASCs; developing medical staff bylaws; and obtaining Medicare certification and private accreditation for ASCs.

• Represented ASCs before CMS Regional Offices and the National Office to obtain coverage for procedures not currently on the CMS ASC procedure list.
• Served as national and local counsel to several of the leading national and international LASIK providers.
• Advised ASCs with regard to the impact of changes in reimbursement brought about by the change to an outpatient prospective payment system.
• Served as national managed care counsel to one of the nation's largest ASC operators.

Imaging Centers

Baker Donelson has assisted hospitals, physicians and proprietary organizations in establishing and acquiring imaging centers, including nuclear camera facilities, MRI facilities, EBT clinics, and formed radiology services joint ventures between physician groups.

• Represented second round venture capitalists in an investment in a national teleradiology provider.

Specialty Hospitals

• Represented client in national development of joint venture heart hospitals with local cardiologists.
• Assisted hospitals in establishing a hospital within a hospital, including rehabilitation, women's health and heart hospitals.
• Represented a national chain of behavioral health hospitals with respect to medical staff and operational issues.

Clinical Laboratories

• Represented a national clinical laboratory provider in establishing joint venture laboratories with hospital providers.
• Advocated on behalf of hospital joint venture laboratories to obtain independent laboratory status from CMS.
• Represented hospitals in spinning off their laboratory operations to proprietary laboratory providers.
• Represented a national provider of pathology services, including its initial roll-up of multiple pathology practices, the acquisition of new pathology practices and negotiations with hospitals and other health care providers to provide pathology services.
• Represented cardiac catheterization labs, sleep labs and other outpatient diagnostic providers, hospitals, physicians and proprietary companies in developing cardiac catheterization laboratories, sleep laboratories, imaging centers including nuclear camera facilities, MRI facilities and EBT facilities.
• Obtained Medicare certification for such facilities, including the determination of provider-based status.

Outpatient Therapy Service Providers

• Represented hospitals and other health care organizations in the development of outpatient therapy service providers, such as radiation oncology centers, proprietary physical therapy centers and outpatient cardiology services.
• Structured a joint venture between a major academic medical center and a large cardiology group practice to provide outpatient cardiology services. This structure has been nationally recognized as the model for hospitals to fortify relationships with staff cardiologists.