Industries & Practices

Health Care Industry

Appeals of RAC denials

Guided multiple hospitals and health systems through the Medicare appeals process for Recovery Audit Contractor (RAC) claim denials and overpayment determinations. This matter involved preparing hospitals for RAC audits and managed appeals involving a wide array of billing issues through the Administrative Law Judge hearing process and Medicare Appeals Council (MAC), when necessary.

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$1.3 billion health system construction projects

Advise and assist Indiana's largest private, not-for-profit health system with three projects that are among the largest construction projects the system has ever undertaken, with total costs expected to exceed $1.3 billion over several years. The first project involves construction of a new campus location in the downtown area. The second project involves a new facility on a university campus. The third project involves renovating 150,000 square feet of the vacated children’s hospital to create a maternity hospital. Bricker’s role is to provide the legal services specific to the construction of health care facilities, while Indiana co-counsel is expected to provide more general construction advice.

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Innovative tax exemption strategy

Obtained a favorable decision from the IRS on behalf of a nonprofit, public sector managed care company involving an innovative legal approach to acquiring tax exempt status.

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Defense of a hospital's leave of absence policy

Represented a hospital in a case where a terminated employee accused the hospital of violating the Family Medical Leave Act (FMLA). We defended the hospital's leave of absence policy and its right to expect employees to comply or be terminated. Our client secured a favorable settlement in mediation three weeks before trial. 

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Complex professional liability insurance provider transaction

Represented a Cayman Island segregated portfolio insurance company that insures providers against professional liability and its shareholders in connection with the sale of shares to a significant Michigan-based health care company. There were numerous financial, regulatory and international law issues associated with the transaction. 

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Health care company as secured creditor

Represented a large non-profit health care company as a secured creditor in a Delaware-based Chapter 11 case. This matter involved assumption and assignment of executory contracts, cure and setoff issues.

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Hospital system acquisition

Represented a large hospital system in successfully dealing with an FTC investigation of an acquisition of a physician specialty practice group. 

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Trade association - FTC

Represented a trade association in resolving an FTC investigation into alleged restrictive association requirements. 

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Noneconomic damage caps

Retained to file an amicus curiae brief on behalf of three organizations in support of the constitutionality of Ohio's noneconomic damage caps applicable to medical negligence cases.

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Pharmaceutical supplier price dispute with nursing home

Successfully defended nursing home in a lawsuit filed by a pharmaceutical supplier based on the defense that the price charged was excessive and not related to maximum allowable cost (MAC) or average wholesale price (AWP) for brand name and generic drugs. 

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Nursing home lost profits claim

Successfully defended hospital against a $4.5 million claim brought by a nursing home seeking to recover lost future profits arising out of failed transfer of Long Term Care Hospital (LTCH) beds from the nursing home to the hospital due to a moratorium imposed by the Center of Medicare & Medicaid Services.

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Hospital design-build project

Assisted with drafting and negotiating design-build contract for a private hospital. Project value exceeded $320 million.

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