McCandlish Holton has a strong health care law practice covering a wide range of issues affecting the health care delivery system. We serve as counsel to hospitals and hospital systems, long-term care facilities, physicians, payors, health maintenance organizations, and various joint ventures among participants in the health care marketplace.

Health Care Corporate and Tax Practice
McCandlish Holton provides strategic business and tax advice to our health care clients. We counsel clients with respect to acquisitions, mergers, joint ventures, restructuring and raising capital. Health Care Team lawyers have extensive experience in structuring group practices and joint ventures among physicians and hospitals or other health care institutions. We also have significant experience representing tax-exempt health care organizations in obtaining and maintaining their tax-exempt status.

Health Care Regulatory and Administrative Issues
Health care providers are subject to regulation by a large number of administrative agencies at the state and federal levels. McCandlish Holton represents health care clients in working with these agencies in the following areas:

• Certificates of Public Need
• Medicare and Medicaid Payment disputes
• Licensure and certification disputes
• Managed care/insurance regulation
• Medicare and Medicaid fraud and abuse compliance
• Antitrust compliance
• OSHA
• Department of Labor issues

Our legal expertise in addressing regulatory issues is supplemented by firm personnel with multidisciplinary training in health administration, public health, and mental health. The firm has a successful health planning and policy practice, with particular expertise in the Certificate of Public Need process. We have third-party reimbursement issues involving Medicare, Medicaid, and private third-party insurers, including recoupment actions and administrative appeals of adverse payment determinations at the state and federal levels. We also routinely advise clients about the reimbursement-related implications of proposed ventures. The Health Care Team is active in resolving issues arising with state insurance regulators as provider networks evolve. McCandlish Holton complements its administrative and regulatory expertise with a strong legislative presence that can provide a regulatory or administrative issues.

Medical Staff
McCandlish Holton has represented both parties in relationships between medical staff members and health care institutions. We often advise hospitals and physicians on questions relating to the credentials or discipline of medical staff members, as well as on questions relating to the composition of medical staffs, hospital-based physician contracts, and other medical staff issues. The firm has experience in consultation and litigation with respect to medical staff antitrust issues.

Managed Care Strategy Development
McCandlish Holton is extensively involved in helping our clients develop and implement strategic responses to changes in the health care industry, specifically those driven by managed care plans and governmental initiatives. We assist hospital and physician clients to develop new models of health care delivery so that they can remain competitive in their dynamic markets.

These new delivery models include:

• Merger of providers
• Multi-hospital networks
• Physician-Hospital Organizations
• Independent Practice Associates
• Medical Service Organizations
• Equity model risk bearing provider networks
• Network development between PHOs and IPAs
• Direct Contracting with self-insured employees

Quality Improvement/Physician Discipline
McCandlish Holton represents hospitals, physicians, and other providers in quality of care cases, as well as those involving license or reimbursement disputes. We often come before the Virginia Board of Medicine, the Medical Society of Virginia Review Organization, and other state licensing boards to resolve disputes.