Health care providers often experience significant delays between the submission of claims to third-party payors and the actual receipt of reimbursement for those claims. This can create cash flow problems for the provider. Our attorneys are experienced assisting all types of providers in obtaining working capital financing based on the provider’s accounts receivable base. We are also experienced in using the “double lock-box” technique to avoid violating the anti-assignment provisions of federal law with respect to accounts receivable from governmental payors such as Medicare and Medicaid.

We represent clients in health care facility Mergers & Acquisitions, as well as those participating in joint ventures formed to own or operate various types of health care facilities. We have served as lead counsel in tax-exempt health system mergers and joint ventures and hundreds of physician practice acquisitions involving thousands of physicians. Our team brings a full range of regulatory expertise to bear in structuring such transactions correctly on the front end. We navigate issues involving state licensing and certificate of need requirements, Medicare, Medicaid, private pay enrollment, conditions of participation, reimbursement, tax-exempt finance, statutory, regulatory and contractual requirements, labor and employment, non-compete, antitrust and all other issues facing major transactions.

We understand that the business of health care depends largely on the economics of reimbursement and that an ever-increasing level of regulatory scrutiny poses considerable challenges to providers’ ability to maintain profitable operations. Through our extensive experience helping clients develop and implement legal strategies to ensure compliance with federal laws, we have direct knowledge concerning the impact of reimbursement issues on health care transactions — specifically, how they affect working capital adjustments, warranties, and indemnification clauses. Our team helps clients decipher complicated Medicare and Medicaid billing and claims administration rules, communicate with regulators and structure compliant business deals to maximize reimbursement. In addition, we provide detailed guidance on various billing and coding matters, from using the appropriate modifiers, incident to billing and location codes to obtaining new Medicare provider numbers.

Representing health care systems and health care facilities, we act as bond counsel for the issue of tax-exempt debt, as borrower’s counsel under master indenture and credit agreements and as lenders’ counsel in commercial real estate financing for construction loan and permanent loan transactions. Our clients value both our attention to detail in documenting the transaction as well as our innovative approach to obtaining much needed financing, whether for hospital expansions, off-campus medical offices, space lease arrangements or the sale of medical office building portfolios. We also assist clients in evaluating tax credits and incentives and complying with regulations related to the use of bond-financed assets and financial covenants in commercial loans.