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Hospital Joint Ventures Legal Handbook

Author(s): Max Reynolds, McDermott, Will & Emery
Details:
  • ISBN-13: 9780763747794
  • ISBN-10:0763747793
  • Hardcover    234 pages      © 2004
Price: International Sales $167.95 US List
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Overview

With hospitals maintaining their lowest operating margins in over a decade, and with one-third of them maintaining negative operating profits, joint venturing with one another and physician groups is a fiscal necessity. However, these ventures are fraught with legal risks. Hospital joint ventures implicate a variety of federal laws, including those related to fraud and abuse, restrictions on tax exempt institutions, anti-trust restrictions, and the issuance of securities. This new book summarizes the pertinent federal laws implicated by joint ventures, identifies risks, and presents strategies by which hospital executives can structure and operate joint ventures which meet their business objectives while minimizing compliance concerns.

ShowKey Features

Provides comprehensive treatment of each distinct body of federal law governing hospital joint ventures. It contains separate chapters on the various types of laws, including health care fraud and abuse, antitrust, securities, and Medicare certification and enrollment. Each chapter details an overview of the particular body of law and an analysis as to how the body of law affects hospital joint ventures.

Provides additional chapters which integrates the laws that govern hospital joint ventures and and describes what steps must be taken to ensure compliance with these laws throughout the various steps in implementing a joint venture. Separate chapters address compliance requirements when selecting investors, structuring the joint venture, and operating the joint venture.

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ShowTable of Contents

Chapter 1. Overview
The Growth of Hospital Joint Ventures
This Work

Chapter 2. Federal Fraud and Abuse Laws Governing Hospital Joint Ventures
Introduction
Anti-Kickback Law
The Stark Law
Exclusion Law

Chapter 3. Federal Tax Laws Governing Hospital Joint Ventures
Introduction
Preservation of Exempt Status
Unrelated Business Income Tax
Restrictions on the Use of Tax Exempt Bond Proceeds
Intermediate Sanctions

Chapter 4. Federal Antitrust Laws Governing Hospital Joint Ventures
Introduction
Application to Hospital Joint Ventures

Chapter 5. Federal Securities Laws Affecting Hospital Joint Ventures
Introduction
Overview of Federal Securities Law
Application to Hospital Joint Ventures

Chapter 6. Medicare Certification & Enrollment
Introduction
General Provisions
Application to Hospital Joint Ventures

Chapter 7. Selecting Investors
Introduction
Fraud & Abuse Compliance
Tax Compliance
Antitrust Compliance
Securities Compliance

Chapter 8. Structuring the Joint Venture
Introduction
Fraud & Abuse Compliance
Tax Compliance
Antitrust compliance
Securities Compliance

Chapter 9. Operating the Joint Venture
Introduction
Fraud & Abuse Issues
Tax Compliance
Antitrust Compliance
Medicare Certification


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ShowAbout the Author(s)

Max Reynolds-McDermott, Will & Emery

Max M. Reynolds is an attorney in the Health Law Department, resident in McDermott, Will & Emery's Washington, D.C. office.  He concentrates his practice on regulatory counseling and fraud and abuse corporate compliance.

Mr. Reynolds regularly counsels acute care hospitals, medical practices, nursing facilities and other health care providers on regulatory issues, including Medicare coverage and reimbursement, health care fraud and abuse compliance, and licensure and accreditation.  He has advised providers on a variety of issues, including those regarding EMTALA, exemption from and the requirements of various Medicare prospective payment systems and fee schedules, establishment of a "hospital within a hospital," securing provider-based status for off-campus facilities, consolidated billing, Medicare coverage of various diagnostic services and CLIA requirements governing clinical laboratory services.

Mr. Reynolds also represents hospitals, physicians, medical equipment suppliers, and pharmaceutical companies on fraud and abuse compliance matters, including analysis of business ventures, commercial strategies, compensation arrangements, gainsharing and recruitment and retention of practitioners.  In addition, Mr. Reynolds represents providers in qui tam actions as well as federal investigations and audits and drafts corporate compliance programs.

Mr. Reynolds has published extensively on Medicare regulatory matters as well as health care fraud and abuse, including articles on EMTALA, the hospital outpatient prospective payment system, the hospital inpatient prospective payment system, the rehabilitation facility prospective payment system and gainsharing.  His articles include "Gainsharing: A Cost-Reduction Strategy that May Be Back," Healthcare Financial Management, January 2002;  "Final Inpatient Rehabilitation PPS Rule Improves on Proposed Rule," Healthcare Financial Management, October 2001;  "EMTALA Liability: Transforming Your Off-Campus Facility into an Emergency Department," Trustee, January 2001;  "Medicare Payment for New Impatient Services and Technologies Requires Expanded Coordination Between Hospitals and Those Conducting Clinical Trials," The RAP Sheet, Summer 2001; and "HCFA's New Restrictions on the Operation of Hospital Outpatient Facilities," Journal of Health Law, Fall 2000.

Mr. Reynolds received a bachelor's degree in political science, summa cum laude and Phi Beta Kappa, from Emory University in 1992.  He earned the JD in 1996 from the University of Virginia.

 

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ShowReviews

  • "Reynolds, an attorney specializing in health law, summarizes the federal laws implicated by hospital joint ventures, identifies the risks that joint venture activities pose under these laws, and suggests strategies by which hospital executives can structure and operate joint ventures in compliance with the law. He describes federal laws relating to health care fraud and abuse, tax, antitrust, securities, and Medicare certification and enrollment, assessing how they are implicated by hospital joint ventures. He also describes regulatory implications and compliance strategies associated with various aspects of the joint venture arrangement, namely investor selection, the structure of the joint venture, and ongoing operation."

    --Book News

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