well ahead
Overview
Ranked as a Tier 1 Healthcare Law Firm by U.S. News-Best Lawyers, Dorsey has a long and prominent reputation for providing sophisticated and effective legal counsel to leading healthcare companies. We take great pride in being a premiere healthcare law firm.
Our clients – hospitals, pharmacies, clinics, device and drug manufacturers, and insurance and services companies, among others – receive Dorsey’s deep and committed industry knowledge with practical and efficient legal advice. They get the best of both worlds – boutique industry focus with the depth of a large law firm. For life sciences clients we provide comprehensive legal representation throughout the entire product life cycle to companies developing innovative products and services to the biotechnology, pharmaceutical, agri-science, and medical device industries.
If your business operates in the rapidly changing healthcare world, you need more than just legal counsel. You need to stay well ahead – identifying and addressing your company’s risks and opportunities.
Technology is quickly changing the way healthcare is delivered and recorded and paid for. Large employers in all industries are adding telemedicine/virtual care visits to their wellness plans; payers and PBMs are partnering with data analytics companies; providers who have implemented EHRs are now adding additional digital services; and technology companies in non-health industries are looking to pivot into offering healthcare technology services – and digital health specifically. As the digital health industry picks up speed, Dorsey’s Healthcare Industry Group is keeping true to its promise to stay “Well Ahead” of industry changes.
With leading industry attorneys around the globe, Dorsey is uniquely positioned to assist in all aspects of the legal, regulatory, and business issues that arise from the use of technology to deliver and improve healthcare and wellness. Our Digital Health experts work closely with our Privacy, FDA, Intellectual Property, Benefits, Licensing, Corporate, Private Equity and Litigation attorneys to deliver practical solutions.
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Our clients need quick and practical answers to complex benefits and compensation questions. We advise employers, large and small, on how to navigate the increasingly complex and regulated employee benefits field. That includes HIPAA, healthcare, privacy, and executive compensation in addition to traditional tax-qualified retirement and pension plans.
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Clients turn to us when they need to understand and navigate the web of highly-technical, and often counter-intuitive, healthcare fraud and abuse rules. We help healthcare providers, manufacturers and insurers to:
- Advise on structuring business transactions to ensure compliance with Stark, anti-kickback, Medicare and Medicaid reimbursement rules, and other healthcare fraud and abuse rules,
- Provide day-to-day business operations analysis regarding fraud and abuse,
- Conduct internal fraud and abuse investigations,
- Handle self-disclosures to OIG and other agencies regarding fraud and abuse issues,
- Represent clients in federal or state fraud and abuse and false claims investigations and lawsuits,
- Represent providers in RAC, ZPIC, and other post-payment audits, and
- Draft, revise, and implement compliance programs.
Hospitals and other healthcare entities rely on Dorsey’s Healthcare Industry Group to provide advice and counsel related to their financings. Dorsey acts as bond counsel, corporate counsel and/or underwriters counsel for a wide range of healthcare financings around the country. We also help hospitals and health systems navigate the ever-expanding and complex securities and IRS disclosures necessary for healthcare financings to ensure compliance throughout the financing process and beyond.
In the healthcare industry, litigation is at best a costly distraction and at worst a grave threat. Even in the smallest dispute, reputations are at stake. That’s why healthcare entities across the country turn to Dorsey for their most important litigation. With extensive industry experience and tested litigation skills, we bring an informed perspective to healthcare disputes.
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A privacy or security breach is among the most feared risk facing any healthcare business. The cost of breach notification obligations, the follow-on HHS investigation and potential penalties and class-action lawsuits combine to make privacy and security issues in today’s world among the most expensive and damaging of legal risks. We provide extensive counsel on HIPAA privacy matters for hospitals, physician groups, health systems, specialty boards, healthcare clearinghouses and healthcare system networks, and many of our lawyers specializing in privacy are certified information privacy professionals. Our healthcare privacy and security practice complements our Privacy and Social Media group with healthcare-specific expertise, and will help you avoid these types of incidents and minimize their impact if they occur.
We work with clients across the healthcare industry, including hospitals, health systems, retirement communities, nursing homes, physician practices, retail and specialty pharmacies, payers of healthcare services and medical device, technology and pharmaceutical companies.
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Dorsey’s 50 years of success and experience in intellectual property litigation has consistently earned our team national recognition. Whether through litigation in the courts or challenges at the patent office, we partner with our clients to find creative solutions for their intellectual property issues at a reasonable cost.
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Dorsey has served clients in the healthcare industry since the 1940s, with clients ranging from the largest healthcare payer in the United States, to one of the world’s most recognizable medical practices, to companies and investors at the forefront of medical innovation. Medical technology companies rely on Dorsey because our attorneys understand the legal and technical issues crucial to success in this rapidly changing industry. Our wide range of expertise and experience, which includes attorneys with scientific/engineering degrees and industry backgrounds, including Ph.D.’s, provides a framework for our clients' success.
Focus on Medical Technology:
- AI/Machine Learning/Bioinformatics
- Biosensors
- Biomaterials
- Superelastic alloys
- Shape memory alloys
- Cardiovascular Devices
- Cardiac Rhythm Management
- Coronary
- Electrophysiology Mapping
- Structural Heart
- Dermatology
- Drug delivery
- Digital Health and Electronic Health Records
- Endoscopy/Laparoscopy
- Gastroenterology
- Gynecology
- Hematology
- Imaging, including MR/Ultrasound/OCT
- Implant and tissue sterilization
- Minimally invasive access/surgical systems
- Microfluidics/Lab-on-a-chip devices
- Neurology
- Neuromodulation
- Neurointerventional systems
- Otolaryngology
- Ophthalmology, including IOLs and stents
- Orthopedics
- Osteobiologic materials and implants
- Pulmonology
- Radiotherapy
- Robotics
- Spine
- Urology
- Wound care
- Patent prosecution, opinions, and litigation support for one of the world’s largest medical device companies in the external and invasive catheter technology area.
- Patent prosecution, opinions, and litigation support for medical device companies in the cardiovascular and cardiology device technology area.
- Patent prosecution and opinions for a fortune 100 medical device company in the puncture closure technology area.
- Patent prosecution and opinions related to injection and infusion devices, osteobiologics and orthobiologics, endovascular, urology, dermatology, otolaryngology (ENT), pulmonology, spine, orthopedics, cardiology, neurology, ophthalmology, gastroenterology, women’s health, robotic surgery, obesity, orthodontics, orthopedics, including sensing and ablating with RF and lasers.
- Represent numerous start-up medical device companies in the U.S. and abroad, such as companies in the arterial and venous pump technology area.
- Developing and executing prosecution strategies—not only to protect a client's products, but also to analyze those of its competitors—to help ensure that the client realizes value from its intellectual property assets
- Preparing and negotiating licenses, assessing the licensing value of competitors' patents, and guiding the client in the decision to license.
- Monitoring the field to know when a client needs a clearance opinion or has a potential interference issue. These efforts can help direct the client in research and development areas that minimize patent obstacles.
- Providing counsel on business-related matters, including antitrust and competition issues, and FDA regulatory issues.
- Advising on potential litigation strategies and, when necessary, deploying experienced trial teams.
- Performed patent due diligence for medtech and life science venture funds.
Dorsey provides experienced healthcare reimbursement counsel involving Medicare, Medicaid, and other payers of healthcare items and services. For decades, healthcare providers, manufacturers and payers have turned to us for counsel in this area. Our expertise in the healthcare reimbursement arena stems from our long-standing knowledge of the healthcare industry and its ever-changing and complex regulatory and reimbursement environment.
We furnish specialized counsel to many providers, medical device manufacturers, pharmaceutical manufacturers, and others on complex matters involving Medicare and Medicaid reimbursement, including coverage issues, clinical trial reimbursement, Medicare enrollment and Change of Ownership rules, Medicare provider-based rules, medical necessity rules, imaging reimbursement and anti-mark-up rules, federal “Stark” compliance, physician and non-physician practitioner reimbursement, corporate practice of medicine, and many others.
Our experience includes hospital inpatient and outpatient reimbursement rules, as well as detailed knowledge of physician service reimbursement, and medical device and pharmaceutical reimbursement matters. We often are called on to handle matters directly with the relevant regulatory agency, including the Centers for Medicare and Medicaid Services (“CMS”), local Medicare Administrative Contractors, the Department of Health and Human Services Office of Inspector General (“OIG”), and State Medicaid agencies. We can help your business respond and appeal reimbursement denials, 340B audits, “meaningful use” audits, post-payment audits (e.g., RAC, PSC, or ZPIC audits), and others.
All players across the pharmacy continuum, including pharmacies, wholesalers, manufacturers and pharmacy benefits managers (PBMs) are among the most highly regulated businesses in the United States, and the consequences of regulatory non-compliance can be serious and expensive. At the same time, the pharmacy industry has seen a great deal of structural change through joint ventures, mergers, acquisitions and other affiliations with opportunities for consolidation, collaboration and new models of service delivery. Dorsey’s Healthcare Industry Group assists these entities in both contexts. The group includes a team of health lawyers with experience assisting pharmacies, including retail, mail order, online, specialty, and safetynet pharmacies; distributors; pharmacy benefits managers, both large and small; and pharmacy-related operations such as pharmacy networks and drug donation depositories. We have advised dozens of pharmacies and PBMs in legal matters including:
- Creation of Policies and Procedures
- Compliance Programs
- VAWD and URAC Accreditation
- OIG and DEA Investigations
- PBM and Payer Audits
- Anti-Kickback and Inducement Issues
- Downstream Entity Obligations, including Fraud, Waste and Abuse Issues
- Retail Rewards and Loyalty Programs
- Licensing and Credentialing
- State Inspections and Investigations
- Big Data and Analytics
- Acquisitions and Corporate Transactions
- Contractual Arrangements and Negotiations
- DEA and Diversion Issues
- HIPAA Training
- Privacy Laws and Privacy Breach Investigations and Responses
- 340B Drug Pricing Issues and Compliance
- Reimbursement Matters
- Medicare and Medicaid
- Telepharmacy Issues
- Formation, Restructuring and new Affiliation Issues
- Vendor Contracts
- Pre-Litigation and Litigation Support
Experience
Client Achievements
- 德汇代表亿腾医药就其收购礼来旗下两款著名抗生素产品希刻劳®和稳可信®以及位于苏州的希刻劳生产工厂提供全面法律服务 Dorsey Represents Eddingpharm in Acquisition of Eli Lilly’s Rights in China for Ceclor® and Vancocin® as well as its Ceclor Manufacturing Facility in Suzhou
- Pay for Success project expands Nurse-Family Partnership to improve health outcomes for first-time moms and their children
- Clients achieve complete dismissal of securities fraud claims
- Coming together to grow nutritional supplement sales in China
- Tekmira and OnCore merge to create global company focused on HBV treatment
Fraud and Abuse
- On behalf of one of the country’s largest health insurers, interacted with governmental agencies on over 30 fraud and abuse matters.
- Represented hospital system in defending Department of Justice allegations of billing fraud, resulting in no claims or action taken.
- Regularly guide healthcare providers through the OIG self-disclosure process arising from Medicare billing issues, recruitment arrangements, Stark violations involving lease arrangements and physician recruitment arrangements, and the hiring of individuals excluded from federal healthcare programs.
- Represented pharmaceutical manufacturers in settlement agreements with the Department of Justice involving anti-kickback allegations.
Pharmacy
- Represented national chain pharmacy in renegotiation of drug wholesaler contract.
- Updated the compliance program for a national pharmacy chain.
- Represented a tax-exempt healthcare system in formation of joint venture, negotiation of professional services agreement and management agreement with for profit retail pharmacy to operate retail clinic staffed with advanced practice nurse professionals provided by the healthcare system.
- Created a corporate and contracting structure for ExceleraRx Corp., a national network of health system-based specialty pharmacies.
- Represented Target Corporation as pharmacy counsel in the sale of its pharmacy assets to CVS Pharmacy, Inc.
- Represented Geneva Woods Pharmacy, Inc. as corporate counsel and in multiple acquisitions in Wyoming, Washington, Idaho and Alaska, including 363 and receivership purchases.
- Represented PBMs in lawsuits alleging violations of ERISA.
Privacy & Security
- A large nationwide health plan client turned to Dorsey to handle the amendment of hundreds of business associate agreements following the enactment of the HITECH Act.
- Dorsey has represented healthcare providers and health plans in connection with investigations under HIPAA conducted by the Department of Health and Human Services – Office of Civil Rights.
- Dorsey regularly assists clients with drafting website policies that are HIPAA-compliant.
- Represent covered entities and business associates in assessing and addressing breach incidents and investigations and the class action lawsuits that often follow.
Healthcare Transactions
- Created a corporate and contracting structure for ExceleraRx Corp. a national network of health system-based specialty pharmacies.
- Represented multi-specialty physician group in development and operation of a joint-venture hospital.
- Represented national chain pharmacy in renegotiation of drug wholesaler contract.
- Lead health counsel for OptumHealth Care Solutions, Inc. in its acquisition of OrthoNet Holdings, Inc.
- Lead health counsel for Collaborative Care Holdings, LLC in its acquisitions of ProHEALTH Medical Management, LLC and WESTMED Practice Partners LLC.
- Lead health counsel to United Healthcare Services, Inc. in its acquisition of the rights to renew certain commercial administrative services business and health insurance membership in the States of Georgia, Indiana and South Carolina.
- Represented numerous multi-hospital healthcare systems on joint ventures with physicians related to diagnostic imaging and ambulatory surgery centers.
- Represented multi-hospital healthcare system in the formation of a joint venture with physical therapy providers.
- Represented a Midwest hospital system and a Northwest hospital system to create a cardiovascular service line “institute” in Midwest and Northwest providing professional services and management services for hospital’s cardiovascular service line.
- Represent numerous healthcare systems to obtain fair market value support for utilization reviews, call coverage, acquisitions, joint ventures, and other integration strategies.
- Represented a leading provider of rehabilitation management services located in the South to structure relationships with advanced practice providers to comply with fraud and abuse, corporate practice of medicine, and scope of practice and supervision requirements in many states.
Health Information Technology
- Represented a leading provider of medical equipment management and service solutions to the US healthcare industry in the negotiation of the purchase of a payroll and HR software-as-a-service tool.
- Successfully resolved two meaningful use audits.
- Represented a large Minnesota-based public company in connection with the drafting and negotiation of a master services agreement (including software-as-a-service for certain tools used in the services) for the implementation, delivery and transition of use of business process outsourcing services by its healthcare provider customer.
- On behalf of first-of-its-kind state health information exchange, negotiated master service and license agreement and statements of work for setting up the a hosted exchange with a major software vendor, and general representation of exchange in consulting services agreements and additional licensing for add on features.
- Represented multiple providers in Iowa in connection with the implementation of their electronic health records systems and ancillary agreements with a variety of electronic health record vendors, including Meditech, LSS, Epic, McKesson, and DrFirst.
- Represent US manufacturers of implantable cardiac products in international product distribution, license, joint development of intellectual property and regulatory matters.
Industries & Practices
Antitrust & Competition Law
Explore This Practice View client achievements related to this practice View resources related to this practiceGovernment Solutions & Investigations
Explore This Practice View client achievements related to this practice View resources related to this practiceIntellectual Property Litigation
Explore This Practice View client achievements related to this practice View resources related to this practiceHealthcare Transactions & Regulations
Explore This Practice View client achievements related to this practice View resources related to this practiceNonprofit & Tax Exempt Organizations
Explore This Practice View client achievements related to this practice View resources related to this practicePatent Prosecution & Strategy
Explore This Practice View client achievements related to this practice View resources related to this practice- Antitrust & Competition Law
- Benefits & Compensation
- ERISA Litigation
- Government Solutions & Investigations
- Healthcare Litigation
- Healthcare Transactions & Regulations
- Intellectual Property Litigation
- Mergers & Acquisitions
- Nonprofit & Tax Exempt Organizations
- Patent Prosecution & Strategy
- Public Finance