Healthcare Law

CG Law is a leader in counseling clients in the healthcare industry.

Our health care practice group provides legal services and business counseling to hospitals, physicians and physician groups, physician organizations, independent practice associations, accountable care organizations, dialysis centers, ambulatory surgery centers, and long-term care facilities. Led by Jason Centolella, our healthcare law practice group handles a broad spectrum of health care legal matters including, hospital affiliations, facility development, managing government investigations, structuring mergers, sales, and acquisitions, HIPAA privacy issues, formation of accountable care organizations, certificate of need and Department of Health approvals, compliance with fraud and abuse laws, and formation of physician organizations and independent practice associations.

Our team of attorneys includes a well-respected surgeon in G. Randall Green, who brings to the Firm, his unique experience as a practicing physician in cardiothoracic surgery.  Randy counsels physicians, physician groups and hospitals in all aspects of healthcare law, with a focus on clinical integration, physician alignment, managed care contracting and network development, and other healthcare transactions.

Our healthcare practice group works in collaboration with our business, tax, employee benefits and real estate. Due to the time sensitive nature of many health care matters, our attorneys are available on a 24 hour basis upon request.

Sub Practice Areas:

Health care providers are pushed to identify new alignment strategies for long-term market success. With knowledge in Pioneer and Advance Payment models and the Medicare Shared Savings Program, we specialize in ACO implementation and will advise your organization every step of the way. Our attorneys have significant experience with ACOs, having formed and acted as general counsel to six ACOs, including four of the original Medicare Shared Savings Program ACOs and one of the first New York State Certified ACOs.

Our attorneys also advise physicians on the formation and operation of independent practice groups, management service organizations (MSOs), independent practice associations (IPAs), physician/hospital organizations (PHOs), and physician organizations. We act as general counsel to many of these organizations handling all day-to-day legal matters.

Additionally, we draft and negotiate ACO network agreements and agreements between ACOs and third party suppliers, such as IT vendors.

One of our team’s top priorities is helping physicians and physician groups meet the everchanging demands of the marketplace. We are an extension of the client, providing them with a strategic and operational counsel for a variety of legal concerns, including regulatory matters, alignment with other physician groups and hospitals, governance matters, employment issues, physician recruitment, and HIPAA matters.

Our attorneys understand the complex aspects of Federal and New York health care regulatory issues and know the best, most effective ways of addressing them. Our team develops strategic plans to address all New York State regulations, federal regulations and, required approvals. We regularly represent clients before federal and other state agencies, including:

  • New York State Department of Health
  • New York State Education Department (NYSED)
  • New York State Office of the Medicaid Inspector General (OMIG)
  • Offices of Mental Health, Persons with Developmental Disabilities and – Alcoholism and Substance Abuse Services
  • Centers for Medicare and Medicaid Services (CMS)
  • Office of Inspector General (OIG)
  • Office of Professional Medical Conduct (OPMC)

Health care fraud is a top priority at CG Law, as an effective compliance program is key to the success of any health care provider’s business ventures and operations. Our team helps clients establish, implement and monitor compliance programs in order to prevent, detect and correct practices that don’t comply with complex fraud and abuse laws, including the Stark Law and Anti-Kickback Statute. We also counsel and defend clients with both prosecutions and investigations into health care fraud allegations by state and federal entities. In addition, we work to identify violations, prevent illegal activity and minimize penalties. Our attorneys regularly work on many False Claims Act-driven government investigations.

Our attorneys have expansive experience representing hospitals and healthcare providers nationwide on all sides of health care M&A transactions to help them achieve a deeper level of integration and collaboration. We focus on hospital/physician joint ventures, hospital affiliations, sales of practices to hospitals, and structuring ancillary service providers such as ambulatory surgery centers. The CG Law team assists these entities in creating and implementing clinical integration through all necessary phases, including:

  • Identifying strategic approaches and conducting due diligence
  • Mobilizing hospitals and other vested stakeholders
  • Solving general employment issues
  • Creating compensation plans
  • Addressing complex privacy issues that arise from data sharing
  • Handling regulatory aspects of implementation, including self-referral and anti-kickback issues
  • Assisting with follow-up operational matters
  • Drafting contracts, network governance documents and policies
  • Handling all matters associated with closing a transaction, including post-closing implementation

The CG Law team is experienced in addressing the unique challenges faced by CAHs.

Hospitals, health care institutions, medical executive committees, and medical staff associations look to us to advise them on various medical staff matters. We review and revise medical staff by-laws, written rules for effective operations, and compliance documents with regulatory and accreditation requirements. We also conduct “root cause” analyses and serve as a counsel for medical staff investigations, impaired professionals, corrective action, and fair hearing and appellate review proceedings. Additionally, we administer regulatory and compliance reviews and provide counseling in credentialing, state and federal records of adverse actions, on-call obligations, and Emergency Medical Treatment and Labor Act (EMTALA). Additionally, we consult physicians and professional clients on licensure matters, scope of practice issues, and matters regarding relationships with other professional and health care businesses.

We provide our clients with reimbursement advice under the Medicare and Medicaid programs. In addition, we counsel them regarding third-party payor managed care contracts, including cost reporting issues, billing compliance, self-disclosures, revenue enhancement, and transaction structuring.

We assist our clients in addressing tax issues that arise in health care businesses from daily operations to transactions. Some of these issues include: private inurement issues, UBTI analysis, tax-free reorganizations, acquisitions and dispositions, sales, joint ventures, spin-offs, and recapitalizations.

Our attorneys are experienced in corporate healthcare, with expansive experience assisting clients in the establishment, development, and maintenance of virtuous governance practices and policies. We work with for-profit, governmental, and tax-exempt clients with the intent of making their governing boards fundamentally more effective.

We regularly work with:

  • Hospitals and health systems
  • Accountable care organizations (ACO) and Clinically Integrated Networks (CIN)
  • Independent physician groups
  • Dialysis Centers and freestanding ambulatory surgery facilities
  • Management Service Organizations
  • Federally Qualified Health Centers
  • Long-term care and home health agencies
  • Nursing homes and assisted-living facilities
  • Private Equity Firms
  • Hospices
  • DME suppliers
  • Independent Practice Associations, Physician Hospital Organizations, and Physician Organizations.
  • Rehabilitation facilities
  • REITs