Health Care is one of the most dynamic and rapidly evolving areas of law. Legislative and regulatory changes at both the federal and state levels of government, along with unprecedented market activity, are presenting health care providers and insurers with daunting financial and regulatory compliance challenges along with major opportunities. Wilson Elser is equipped to provide health care clients seeking to thrive in this new environment with a unique combination of resources.

It is precisely the synergy between these two practice areas that enables us to provide our clients with the highest-caliber services and allows our clients to achieve their goals and objectives in the most expeditious manner.

We offer the strength and superior support capabilities of a large national firm, coupled with the personalized service of teams of health care and government relations lawyers specializing in health care transactions and the unique regulatory and legislative environment in which health care clients must operate.

The highly skilled attorneys of Wilson Elser’s Health Care practice work closely with clients in addressing the myriad complex issues that those clients encounter in a constantly changing health care operational and regulatory environment. We find innovative ways to ease compliance burdens and provide creative, cost-effective strategies to complete transactions.

Members of the practice have substantial health care-related experience, many having held prominent leadership positions in government, health care associations and the health care industry. We also have a broad range of experience providing business, transactional and regulatory guidance, along with litigation services, to health care providers and insurers, including individual hospitals, health care networks, physician groups, clinics, nursing homes, home health agencies, adult homes, managed care entities and other health care providers.

Wilson Elser’s Health Care practice is closely integrated with our Government Affairs practice to offer clients a dynamic multidisciplinary blend of experience and innovative counsel in addressing complex state and federal health care matters requiring interaction with government.

The following are representative of the types of health care services Wilson Elser offers its clients:

Counsel/Entity Operations/Transactional

  • General counsel services to health care organizations
  • For-profit / not-for-profit governance issues
  • Health care administrative and regulatory compliance
  • Medicaid fraud and abuse compliance
  • Medicare fraud and abuse compliance
  • Medical privacy, including HIPAA and HITECH privacy, security and breach notification rules
  • Managed care contracting 
  • Contracting for ancillary services 
  • General health care business contracting and leasing
  • Asset purchase and transfer agreements
  • Medical technology acquisition 
  • Physician and other health care professional employment agreements 
  • Professional licensing and disciplinary matters
  • Medical staff governance and bylaws
  • Medical staff fair hearings
  • Physician recruitment arrangements
  • Development and construction of health care facilities and operations, including the certificate of need (CON) process

Health Care Networks and Restructuring

  • Formation / reorganization of health care systems 
  • Creation and operation of multi-provider networks
  • Joint ventures and partnerships among health care providers 
  • Formation of hospital-affiliated physician groups 
  • Acquisition of physician practices by hospitals
  • Creation and operational assistance to provider- and insurer-based entities providing practice management and electronic medical record assistance to providers

Investigations/Litigation/Proceedings

  • Complex civil litigation regarding health care law and policy
  • Government audits, surveys, hearings and investigations (Office of Medicaid Inspector General, New York Attorney General Fraud Control Unit, New York State Department of Health, New York State Department of Labor, Office of Professional Medical Conduct, Office of the Professions) 
  • Provider payment and reimbursement rate appeals

Health Care Law

Health Care Law

Events

Health Care is one of the most dynamic and rapidly evolving areas of law. Legislative and regulatory changes at both the federal and state levels of government, along with unprecedented market activity, are presenting health care providers and insurers with daunting financial and regulatory compliance challenges along with major opportunities. Wilson Elser is equipped to provide health care clients seeking to thrive in this new environment with a unique combination of resources.

It is precisely the synergy between these two practice areas that enables us to provide our clients with the highest-caliber services and allows our clients to achieve their goals and objectives in the most expeditious manner.

We offer the strength and superior support capabilities of a large national firm, coupled with the personalized service of teams of health care and government relations lawyers specializing in health care transactions and the unique regulatory and legislative environment in which health care clients must operate.

The highly skilled attorneys of Wilson Elser’s Health Care practice work closely with clients in addressing the myriad complex issues that those clients encounter in a constantly changing health care operational and regulatory environment. We find innovative ways to ease compliance burdens and provide creative, cost-effective strategies to complete transactions.

Members of the practice have substantial health care-related experience, many having held prominent leadership positions in government, health care associations and the health care industry. We also have a broad range of experience providing business, transactional and regulatory guidance, along with litigation services, to health care providers and insurers, including individual hospitals, health care networks, physician groups, clinics, nursing homes, home health agencies, adult homes, managed care entities and other health care providers.

Wilson Elser’s Health Care practice is closely integrated with our Government Affairs practice to offer clients a dynamic multidisciplinary blend of experience and innovative counsel in addressing complex state and federal health care matters requiring interaction with government.

The following are representative of the types of health care services Wilson Elser offers its clients:

Counsel/Entity Operations/Transactional

  • General counsel services to health care organizations
  • For-profit / not-for-profit governance issues
  • Health care administrative and regulatory compliance
  • Medicaid fraud and abuse compliance
  • Medicare fraud and abuse compliance
  • Medical privacy, including HIPAA and HITECH privacy, security and breach notification rules
  • Managed care contracting 
  • Contracting for ancillary services 
  • General health care business contracting and leasing
  • Asset purchase and transfer agreements
  • Medical technology acquisition 
  • Physician and other health care professional employment agreements 
  • Professional licensing and disciplinary matters
  • Medical staff governance and bylaws
  • Medical staff fair hearings
  • Physician recruitment arrangements
  • Development and construction of health care facilities and operations, including the certificate of need (CON) process

Health Care Networks and Restructuring

  • Formation / reorganization of health care systems 
  • Creation and operation of multi-provider networks
  • Joint ventures and partnerships among health care providers 
  • Formation of hospital-affiliated physician groups 
  • Acquisition of physician practices by hospitals
  • Creation and operational assistance to provider- and insurer-based entities providing practice management and electronic medical record assistance to providers

Investigations/Litigation/Proceedings

  • Complex civil litigation regarding health care law and policy
  • Government audits, surveys, hearings and investigations (Office of Medicaid Inspector General, New York Attorney General Fraud Control Unit, New York State Department of Health, New York State Department of Labor, Office of Professional Medical Conduct, Office of the Professions) 
  • Provider payment and reimbursement rate appeals

Health Care Law

Fernandez, Peticca & Holland Obtain Dismissal in Nursing Home Wrongful Death COVID-19 Immunity Case

​Emily Fernandez (Partner-White Plains, NY), Christopher Peticca (Associate-White Plains, NY), and Nicole Holland (Of Counsel-White Plains, NY) obtained dismissal of a wrongful death case on behalf of nursing home client based on COVID-19 immunity pursuant to the EDTPA. The action involved claims of medical malpractice and nursing home negligence in the care and treatment rendered to the plaintiff’s decedent allegedly resulting in COVID-19 infection and death. We drafted a motion to dismiss arguing that the medical records and policies implemented by the facility in response to the COVID-19 pandemic established that the decedent’s care was impacted by the pandemic, thus triggering immunity provided by the Emergency or Disaster Treatment Protection Act (EDTPA). The motion further argued that no exception to the EDTPA applied because the plaintiff failed to properly plead allegations of gross negligence, recklessness, and willfulness, as such claims were conclusory and not sufficiently distinct from the underlying negligence claims. In opposition, the plaintiff argued that we failed to conclusively establish whether the decedent’s care was in fact impacted by the pandemic and that further discovery was needed to meet that burden. The plaintiff also argued that claims of gross negligence, recklessness, and willfulness provided an exception for the EDTPA and required the motion to be denied. However, on reply, based in part on an analysis of the same case law that plaintiff submitted in opposition, we established that plaintiff’s argument was flawed and that we had indeed met the standard for EDTPA immunity in a nursing home negligence case. Specifically, we established that the plaintiff’s conclusory claims of recklessness were insufficient to provide an exception to the EDTPA and that medical records and relevant COVID-19-related policies proved that the treatment at issue was impacted by the pandemic. After oral argument on the motion in Supreme Court, Kings County, the case was dismissed in its entirety.

Emily L. Fernandez, Christopher J. Peticca and Nicole Holland

Boulé and Scoditti Obtain Jury Verdict in Favor of NY’s Largest Health Care Provider

Eugene Boulé (Partner-New York, NY) and Elizabeth Scoditti (Associate-New York, NY) successfully defended New York's largest health care provider in a premises liability action in Richmond County Supreme Court. The jury returned a verdict in favor of a Staten Island hospital following a one-week trial. The plaintiff claimed she seriously injured herself when she was forced to walk on an uneven, 12-inch wide strip of concrete where no signs or barricades were present to prevent pedestrian access. She further alleged that this strip of concrete was similar in color to the adjacent walkway, thereby appearing to be an extension of the walkway and that the hospital failed to take any measures to ensure this area was safe. Gene and Elizabeth argued that no reasonable person would assume the 12-inch strip was a walkway, and therefore it was not foreseeable that the plaintiff or anyone else would have walked on it. They also presented the jury with other sensible routes the plaintiff could have taken if she were acting reasonably. The jury concluded that the plaintiff failed to meet her burden of proof with credible evidence and found no negligence on the part of the hospital. The settlement demand to the hospital was never less than $1.25 million throughout the trial.

Eugene T. Boulé and Elizabeth Scoditti

Holland Achieves Unanimous Defense Verdict for Assisted-Living Facility after Five-Day Jury Trial

Andrew Holland (Of Counsel-Houston) obtained a unanimous defense verdict in Ulster County, New York, Supreme Court for an assisted-living facility after a five-day jury trial. The firm’s client operates an adult care facility with a memory care unit that must be secured to prevent the residents from leaving. The plaintiff’s decedent, a long-time resident, had advanced Alzheimer’s disease but was physically capable and ambulatory. The resident was seated in a chair that had caster wheels on the front feet to assist with mobility, but after he stood up, he fell, and the chair rolled backwards, according to the incident report, and he sustained a hip fracture requiring nail fixation surgery. After his hospitalization for the surgery, the resident was transferred into skilled nursing care, confined to a wheelchair and died six months later. The plaintiff called a Registered Nurse as her liability expert, who claimed that these chairs are dangerous because residents with Alzheimer’s and dementia forget that the wheels are there, creating a safety hazard. We called a mechanical engineer who performed a forensic analysis of an exemplar chair with wheels, as well as one without wheels, and found the slide characteristics and rotational balancing points to be virtually the same. We also called a physician board-certified in internal medicine and specializing in geriatric medicine, who testified that not only are these chairs acceptable under the standard of care, but the wheels are actually a safety feature insofar as they allow residents to move chairs independently while diminishing the risk of the user tipping over or sliding out from the chair. He believed it was more likely that the resident lost his balance or felt lightheaded after rising and fell backward, pushing the chair back. Lastly, we emphasized the fact that not a single witness put forth any evidence that a fall had ever occurred because a chair with mobility-assistance wheels rolled out, as the plaintiff theorized. The jury reached a unanimous defense verdict within 25 minutes of commencing deliberations.

Andrew S. Holland

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