Health Care

  • Representation of the American Medical Association, the American Dental Association, the American College of Surgeons, the American Academy of Family Physicians, the American College of Radiology, the American Psychological Association, Blue Cross Blue Shield Association, and various other health care associations in the preparation and filing of numerous briefs amicus curiae before the United States Supreme Court, federal courts of appeals, and state supreme courts in cases involving important legal, medical, and mental health issues.
     
  • Representation of American Association of Electrodiagnostic Medicine in successful defense of litigation brought by medical device manufacturer charging that AAEM's publication of review of literature on the manufacturer's product disparaged the product in violation of the Lanham Act and state injurious falsehood laws. The federal district court granted AAEM's motion for summary judgment.
     
  • Representation of national medical specialty society in defense of litigation challenging society's decision to overturn its election for president-elect.  The federal district court denied the plaintiff's motion for preliminary injunction.
     
  • Representation of a dozen medical specialty societies, including the American Society of Cataract and Refractive Surgery, the American College of Orthopedic Surgeons, the American Association of Neurological Surgeons, the American Academy of Ophthalmology, and the American College of Cardiology in challenging the Health Care Financing Administration's transition formula for implementing the resource-based practice expense component of the Medicare physician fee schedule.
     
  • Representation of the American Academy of Pediatrics in its successful defense against antitrust charges brought by Nestle for allegedly conspiring to restrain trade in the infant formula market.
     
  • Representation of the American Society of Cataract and Refractive Surgery in three successive federal court challenges to Medicare reimbursement policies affecting physicians' fees for cataract surgery.
     
  • Representation of a Kentucky surgeon in successfully obtaining a decision from the United States Court of Appeals for the Sixth Circuit overturning the largest fine ever imposed against a physician under EMTALA.
     
  • Representation of a Vermont ophthalmologist and the Dartmouth Hitchcock Clinic in successfully defeating a landmark patent infringement action to enforce an Arizona ophthalmologist's patent on the shape and location of the initial incision for cataract surgery.
     
  • Representation of Blue Cross Blue Shield Association in litigation in Maryland federal district court and related settlement negotiations regarding CareFirst’s right to continue as a Blue Cross Blue Shield Company in connection with a new Maryland law enacted in response to CareFirst’s plans to convert to a for-profit organization and merge with WellPoint Health Networks, Inc.
     
  • Representation of Blue Cross Blue Shield Association in Ohio federal district court and the Sixth Circuit Court of Appeals regarding BCBSA's successful defense of its termination of the trademark license agreement of Blue Cross Blue Shield of Ohio in connection with the Ohio licensee's proposed merger with Columbia/HCA. 
     
  • Representation of University of Chicago Hospitals in government investigation arising from voluntary disclosure, and subsequently-filed qui tam lawsuit involving allegations of improper billing to Medicare and Medicaid based on billing for services rendered by residents with inadequate supervision by teaching physicians and upcoding.
     
  • Representation of University of Chicago Hospitals in a qui tam action against the Hospitals filed under the False Claims Act alleging that one of its faculty had misused federal research grant funds given to the University for cancer research by using them in his private business.
     
  • Representation of the University of Chicago Hospitals in litigation involving novel issues arising under the Federal Emergency Medical Treatment and Active Labor Act (EMTALA).
     
  • Representation of president of Evanston Hospital Corporation in successfully defending action brought by real estate developer against Hospital and two of its officers, alleging that his failure to develop medical building was caused by misleading statements by the officers and by a physician boycott organized by the Hospital.  The plaintiff's claims included allegations of racketeering, antitrust violations, fraud, promissory estoppel, and health care fraud.
     
  • Representation of Childrens' Memorial Hospital of Chicago in successful litigation enjoining enforcement of statewide regulations.
     
  • Representation of major biotech/pharmaceutical company in litigation brought by government involving alleged off-label marketing of a pharmaceutical product and payment of kickbacks to physicians disguised as grant payments.
     
  • Representation of international microkeratome manufacturer in defense of patent infringement action brought by competing microkeratome manufacturer.
  • Representation of numerous medical societies, individual providers, and group practices in issuing interpretations, influencing rulemakings, and defending prosecutions under the anti-kickback and "Stark II" provisions of the Medicare/Medicaid laws.
     
  • Representation of a managed care entity in conducting top-level compliance review to address management problems and defend plan in investigation for Medicare and Medicaid fraud by HCFA and violations of state insurance regulations by the Illinois Department of Insurance. 
     
  • Representation of Health Care Services Corporation (major health benefits insurers and managed care organizations) in developing a firmwide corporate integrity and fraud and abuse compliance program.
     
  • Representation of the CFO of a hospital chain that is under investigation for alleged coding violations and other alleged improper billing practices, and related counseling on future billing practices under Government medical reimbursement programs.
     
  • Representation of Takeda Chemical Industries, Ltd., in connection with multiple class actions alleging fraud in the pricing, sales and marketing by a related entity of pharmaceutical products.
     
  • Representation of Health Care Billing Co., a subsidiary of the Oxford Companies, in performing compliance review to identify risk areas under the federal fraud and abuse billing guidelines.
     
  • Representation of a teaching hospital in an investigation by the U.S. Department of Health and Human Services' Office of Inspector General (and subsequent qui tam action) under the PATH (Physicians at Teaching Hospitals) program, the 72-Hour Window Project, and other billing inquiries.
     
  • Representation of several Medicare carriers in defense of governmental probes and/or qui tam litigation involving claims of Medicare billing fraud.
     
  • Representation of individual physician practice groups in developing fraud and abuse compliance plans, and representation of national medical societies in developing model fraud and abuse compliance plans for their members.
     
  • Representation of the Board of Trustees of the American Medical Association in a confidential internal investigation.
     
  • Successful defense of multiple healthcare providers and hospitals in connection with false claims act litigation, grand jury and/or regulatory investigations.
  • Development of HIPAA model policies, procedures, and documents for various national medical societies.
     
  • Development of combined Business Associate/Data Use agreements for use by national medical societies in national outcomes database projects with participating hospitals and physicians.
     
  • Development of HIPAA policies, procedures, and documents for various physician groups and companies that provide services for such groups.
  • Representation of a large multinational pharmaceutical company in connection with various licensing, patent, FDA collaboration and supply agreement related issues. 
     
  • Representation of Cardinal Health, Inc. in its recent acquisition of Care Fusion, Inc., an industry leader in wireless, barcode-enabled patient identification systems.  
     
  • Representation of Honeywell International Inc. and a newly formed subsidiary, Honeywell HomMed LLC in the acquisition of HomMed LLC, a provider of home health care products and services.  
     
  • Representation of the life sciences division of a large Japanese company in connection with forming a joint venture for research regarding the human proteome and commercialization of such research.  
     
  • Representation of a large multinational pharmaceutical company in providing broad ranging corporate and other advice, including representation in connection with a significant corporate transaction.   
     
  • Representation of a medication management and medical supply solutions company on general corporate matters, including pre-IPO venture capital financing.  The company went public and remains as an independent company.  
     
  • Representation of Comprehensive Decubitus Therapy, Inc. (dba Advanced Tissue Management) in various ongoing corporate and transactional matters.  
     
  • Representation of a large medical device company in connection with evaluating certain licenses for stent devices for use in medical treatments and formulating a strategy for renegotiating or sublicensing those licenses. 
     
  • Representation of a biotech and pharmaceutical instrumentation company in connection with licenses for labeling and detection systems. 
     
  • Representation (as co-counsel with Wachtell, Lipton, Rosen & Katz) of Cardinal Health, Inc. in its acquisition of Syncor International Corporation, a leader in nuclear pharmacy services.  
     
  • Representation of a cancer drug development company in a series of financing and related transactions, including detailed familiarity with the company’s in-and out-licensing programs, as well as the drug testing and approval process.  The company went public and was eventually sold to Genzyme.   
     
  • Representation of a multinational corporation in the disposition of its pacemaker business to a publicly-traded medical device manufacturing company, with operations throughout the EU and South America.  
     
  • Representation of private equity fund in its preferred stock investment in a privately-held company that develops and commercializes high content screening, informatics and cellular bioinformatics products for use by companies in the drug discovery market.  
     
  • Representation of a large pharmaceutical company in the divestiture of various of its business units in the food ingredient and biotechnology industries.  This representation included the negotiation of several license agreements and research and development agreements for chemicals and biotech materials.  
     
  • Representation of a large chemical company in connection with evaluating certain of its licenses for chemical agents for use in medical treatments and formulating a strategy for re-negotiating such licenses.  
     
  • Representation of a molecular electronics company in connection with licensing core intellectual property rights from several prominent universities, which licenses included equity investments by several of the universities involved.  
     
  • Representation of a large consumer products company in connection with a license for a chemical composition and manufacturing process.  
     
  • Represented a large not-for-profit organization in the medical industry in connection with its licensing and supply agreements with a major medical supply company.  
     
  • Represented a large consumer products company in connection with the acquisition of a worldwide business primarily involving chemical ingredients.  
     
  • Representation of Dynacare, Inc., a provider of clinical laboratory testing services, in its sale to Laboratory Corporation of America Holdings in an approximately $450 million merger transaction.  
     
  • Representation of a financial sponsor in connection with forming a company and related fund to make investments in late-stage healthcare companies and products.   
     
  • Representation of Sterling Capital Partners in its acquisition of Ameritox Ltd.
     
  • Representation of three separate nursing specialty certification boards in amicable negotiation of autonomy from their related nursing professional societies. 
     
  • Representation of countless health care professional societies and certification organizations in drafting formation documents and in obtaining nonprofit, tax-exempt status. 
     
  • Representation of individual physicians and practice groups in drafting and negotiating employment, independent contractor, and managed care agreements, as well as exclusive professional services agreements on behalf of hospital-based physicians. 
     
  • Representation of the large national medical specialty society in drafting model managed care agreement. 
     
  • Representation of physicians in the formation of physician-owned networks to negotiate with managed care organizations, insurance companies, employers, and other third-party payors. 
     
  • Representation of numerous medical specialty societies and other organizations in drafting and negotiating agreements with the federal government and subgrantees for the receipt and use of federal grants for health care research. 
     
  • Representation of numerous medical specialty societies in the drafting and negotiating of agreements between medical specialty societies and software suppliers, database managers, and other entities for the development, marketing, and dissemination of outcomes database software. 
     
  • Representation of numerous health care associations in drafting and negotiation of vendor, licensing, and publishing agreements and in establishing for-profit subsidiaries to conduct e-health business, to develop, market, and disseminate practice management software, and for various other purposes.
  • Representation of the Patient Access to Specialty Care Coalition in advocacy efforts regarding various patient protection bills.
     
  • Representation of the American Society of Cataract and Refractive Surgery, the American Academy of Dermatology and a coalition of 17 medical societies (including the American Medical Association, the American College of Radiology, and the American College of Surgeons) in successfully promoting legislation to limit the enforcement of patents on medical and surgical procedures against medical practitioners and their related health care entities.
     
  • Representation of the American College of Emergency Physicians in efforts to enact national legislation defining the criteria for reimbursing managed care patients for the cost of emergency medical services.
     
  • Representation of the American Dental Assistants Association in conceiving and lobbying for the Consumer-Patient Radiation Health and Safety Act requiring states to license those who operate x-ray equipment.
     
  • Representation of the American College of Radiology in the creation of a radiology relative value scale and its translation into the first Medicare Part B physicians' fee schedule.
     
  • Representation of many national medical societies, other health care organizations, and various pharmaceutical and medical device companies in their relationships with federal regulatory authorities at the Food and Drug Administration, the Centers for Medicare and Medicaid Services, the HHS Office of Inspector General, the Department of Justice, and the Federal Trade Commission.
     
  • Representation of many national medical societies in drafting comments and providing member analyses on health care regulatory issues such as the HIPAA patient privacy rules, the Stark II self-referral laws, Medicare-Medicaid antikickback rules, Civil Monetary Penalties, Medicare billing and coding rules and documentation guidelines, and various national and local coverage issues.
     
  • Representation of a major medical specialty society in its drafting of a comprehensive code of ethics for members and the successful attainment of Federal Trade Commission approval of the code, one of the few such approvals ever granted by FTC.
     
  • Representation of numerous associations, corporations, and individual practitioners in developing compliance programs mandated by federal laws to restrict transmission of infectious diseases in the Workplace (e.g., OSHA Bloodborne Pathogens Standard and Centers for Disease Control Guidelines) and to prevent discrimination on the basis of disability (Americans with Disabilities Act).
     
  • Representation of the American Society of Cataract and Refractive Surgery in developing a multi-forum campaign against a proposed Medicare reimbursement demonstration project.
     
  • Representation of the American Orthotic and Prosthetic Association, and a related credentialing board and professional society, in a Federal Trade Commission proceeding to disaffiliate the three groups and strike down the credentialing board's criteria as anticompetitive; the agency ultimately was persuaded to dismiss the matter with no penalty to the organizations.