The health care group of Bricker & Eckler LLP is one of the largest in Ohio and the nation with 32 attorneys practicing with the group.

Representation of Health Care Providers

We currently provide legal services to over two-thirds of the hospitals, individually or as systems or networks, in Ohio, and are also actively representing hospitals across the country in a variety of issues. Through our affiliated consulting company, The Quality Management Consulting Group, we are providing health care consulting services in 33 states. Bricker & Eckler LLP also represents a large number of other health care providers, including retirement communities, skilled nursing facilities, physician/hospital organizations, provider networks, physicians, physician group practices, integrated delivery systems, IPA's and home health agencies.

Representation of Health Care Associations

In Ohio we represent several health care trade associations, including the Ohio Hospital Association, the Greater Dayton Area Hospital Association, the Ohio Osteopathic Association, and the Ohio Dental Association. Our involvement with the OHA and the other trade associations gives us unique insight into developments at a state-wide, regional, and national level. We also successfully represented the American Hospital Association and the Ohio Hospital Association in federal litigation involving laboratory unbundling/false claims.

In addition, we maintain and update the Ohio Hospital Association Compliance Manual for OHA members and the American Hospital Association Regulatory Compliance Manual for AHA members.

Representation of Multi-Hospital Groups

We have extensive experience in the representation of multi-hospital groups, which gives us the advantage of knowing what are the current and anticipated health care issues in Ohio and nationally, as well as extensive knowledge of the collective attempts to address those issues. For example, Bricker & Eckler LLP has handled a number of reimbursement group appeals, including appeals on behalf of the OHA on Medicare reimbursement issues. Bricker & Eckler LLP also successfully represented the hospitals in Ohio in a suit to increase Medicaid reimbursement for all the hospitals in the State. Bricker & Eckler LLP is currently working with a substantial number of the hospitals that are undergoing false claims investigations.

We also represented all Dayton hospitals in the development of the Dayton Area Health Plan, which was the pilot Medicaid mandatory enrollment managed care program that is now being expanded throughout the State. Additionally, we represented all Dayton hospitals in the negotiation and development of an indigent care levy to provide taxpayer support for the care of indigents in Montgomery County.

Development of Health Care Provider Networks

Our experience in the development of regional health care networks is extensive. For example, we have had experience with the following types of health care providers in the development of networks:

• Development of a regional health care network of nineteen hospitals.
• Organization of six hospitals and over 1,000 physicians into a managed care network to permit academic health care centers to actively compete in the managed care marketplace.
• Corporate integration of seven hospitals under a common parent, the development of a health care PPO that currently has more than 100,000 covered lives, the development of a regional alliance, and the formation of a provider-controlled HMO.
• Development of both a state-wide and regional PHO for hospitals and physicians.
• Development of an HMO owned by 14 hospitals to enable the hospitals and their medical staffs to sell a locally controlled managed care plan.
• Development of a mandatory Medicaid managed care project for one Ohio county.

In addition to the above, we have been involved in over 45 hospital mergers, or corporate affiliations for the development of local hospital networks.

Delivery of Health Care Legal Services

As reflected in the numerous representations of the health care entities referenced above, Bricker & Eckler LLP is skilled in a vast array of health care related areas of practice. The legal services that we provide to health care providers, including hospitals, long-term care facilities, integrated delivery networks, home health providers and other health care entities include the following areas of practice:

• antitrust
• Medicare/Medicaid reimbursement appeals and certification
• compliance programming
• fraud and abuse and false claims issues and investigations
• integrated delivery systems and development of networks
• facility licensure, accreditation, certification and health planning
• managed care and other third party payer contracting
• general hospital contracting
• public law compliance for governmental hospitals
• mergers, affiliations and acquisitions
• general corporate issues
• PHO, MSO, and similar type arrangements
• physician practice acquisitions
• medical staff issues, including bylaws, credentialing, peer review, and disciplinary hearings
• general hospital/patient issues, including patient rights, consents, advanced directives, and COBRA anti-dumping provisions
• ERISA
• insurance, including the development of captive insurance companies, provider controlled HMOs and PPOs, and other health insurance products
• state and federal regulatory issues
• federal, state and local tax, including non-profit and charitable status issues
• public finance
• environmental regulations and issues
• labor and employment relations
• litigation, including malpractice defense
• privacy issues and cyberlaw application
• software and intellectual property licensing

Together with our affiliated consulting company, The Quality Management Consulting Group, Ltd., we can oversee and provide:

• Physician quality assessments for purposes of credentialing, corrective actions, and clinical evaluations of PHOs and IDSs through a national panel of physician experts;
• The revision and refining of credentialing and quality assessment and performance improvement programs;
• Preparation of a hospital and medical staff for accreditation;
• Medical staff strategic planning;
• Mediation of clinical/quality issues;
• Charge description master reviews;
• Assessment of hospital processes, policies and procedures in relation to billing requirements;
• Evaluation of accuracy of ICD-9 diagnosis and procedure coding;
• Outpatient procedure coding review;
• Home health, hospice, SNF billing and policies audits; and
• Education and training for billers, coders, and others involved in the hospital billing process.

Our health care attorneys are frequent speakers on a variety of health care issues and have given presentations in such diverse forums as: the American Health Lawyers Association, Ohio Hospital Association, Association of Ohio Philanthropic Homes for the Aging, Washington G-2 Reports, Greater Dayton Area Hospital Association, Greater New York Hospital Association, Hospital Council of Northwest Ohio, Indiana Association for Health Care Quality, American Bar Association, Montana Hospital Association, Health Care Financial Management Association, Ohio Society of Certified Public Accountants, Pennsylvania Hospital Association, West Virginia Health Care Authority, Michigan Hospital Association and the American Health Planning Association.