Jenner & Block

Academic Health Systems

Jenner & Block has deep and rich experience in a variety of areas affecting academic health systems.  Our competitive advantage is not in technical knowledge, though we have much of it.  Our advantage is that our team brings the experience and perspective of the very governmental agencies with which academic health systems deal on a day-in, day-out basis as they advances their mission.  From a former health care fraud coordinator for a U.S. Attorney’s office and former DOJ officials with deep civil investigative, litigation, and negotiation experience, to a former Chief Privacy Officer and an in-house information governance specialist for a major university, we bring an understanding not only of the issues, but of the policy and enforcement space in which academic health systems operate.

We have represented hospitals, teaching hospitals, and related institutions both in litigation and in OIG investigations.  We have one of the largest practices in the country for the representation of national associations of and certification bodies for health care professionals and providers, and represent numerous voluntary and charitable health organizations.  We understand the critical role that health care associations and their related certification and accreditation bodies play in advancing the quality of health care in this country.  We have created university privacy programs and have a strong compliance background, including service as monitors in settlements with government agencies.

When our clients face problems, our goal is to develop a legal strategy that integrates with the client's overall business and public relations interests.  But long before then, our goal is to have a relationship with our clients through which we can prevent problems from arising.

Representative matters include the following:

  • 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 Children’s Memorial Hospital of Chicago in successful litigation enjoining enforcement of statewide regulations.
  • Representation of a large public university in a federal investigation into regulatory compliance of university health system.
  • 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 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 a physician group in a qui tam action alleging submission of false claims and violation of the anti-kickback statute.
  • Representation of a physician group in an investigation into coding practices.
  • Representation of a national medical billing company in a false claims investigation.
  • 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.
  • Development of HIPAA model policies, procedures, and documents for various national medical societies and physician groups.
  • 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 anti-kickback rules, Civil Monetary Penalties, Medicare billing and coding rules and documentation guidelines, and various national and local coverage issues.