What We Do?
Health care in the United States is governed by a patchwork of federal, state, and local laws that result in tremendous regulatory complexity for businesses. This patchwork of law cannot keep pace with advances in health technology and innovation. Communication technologies such as telemedicine have made it possible for health service providers to seamlessly reach populations anywhere across the world. However, each state, country, health plan, and insurance program has its own set of rules to navigate. We specialize in helping businesses grow and thrive within this complex legal environment by supporting the development of practical and compliant solutions and legal structures based on your specific business needs.
Multi-State Telehealth Solutions
Providing clinical services across multiple states requires specialized legal structures and regulatory approaches for complying with the rules and restrictions under each state’s medical, telehealth, privacy, corporate practice of medicine and other health care laws. We specialize in developing practical solutions for managing this complexity and enabling scalable growth across states.
Payor Contracting and Value-Based Care
Telehealth, digital health, and other technology enabled care delivery models often lead to challenges relating to health plan contracting because they do not squarely fit within existing contracting and reimbursement pathways or involve a novel combination of services that may include both clinical and non-clinical features. Value-based care, with its own dynamic, novel innovations adds further layers of complexity in the contracting world. We specialize in helping businesses overcome these challenges and support health care organizations in their partnerships with health plans and government payors, including complying with health insurance, managed care, and government program requirements; managing and expanding risk-based arrangements, drafting and negotiating agreements; and advising on reimbursement pathways, business development opportunities, and government policies.
Health Laws & Regulations
We have specialized, deep experience across the broad spectrum of laws and regulations that uniquely impact health care organizations. Many of these laws apply universally within the health care industry. The ability of technology-enabled practices to reach populations in multiple states with different laws and the fusion of technology-enabled care with value-based care is an appealing draw for health care innovators and venture capitalists. However, because advances in technology continue to outpace advances in law, technology-enabled health care models are confronted with a uniquely complex set of legal challenges.
Privacy and Security
The proliferation of new telehealth and digital health solutions is creating new paradigms for the use and exchange of data among health care organizations and health care adjacent technology platforms (e.g., for artificial intelligence, predictive analytics, risk modeling, care management, clinical decision support, and research). In this environment, compliance with the patchwork of state and federal privacy laws is often challenging and small oversights can expose business to substantial liability and reputational risk.
Outside General Counsel
Drawing on our experiences inside the legal departments of both large digital health organizations and large national law firms, we provide comprehensive outside general counsel services to a select number of digital health and telehealth organizations. These services include both in depth, specialized legal support on health-law and health-industry specific legal matters and general-counsel level support on the widely varied legal issues that impact all technology businesses (e.g., general corporate, human resources and workforce management, contracting, etc.).
Strategy
Capitalizing on opportunities to advance health care products and services requires an understanding of the U.S. health care system and the complex set of rules, policies, and payment programs underlying it. As specialists in health care and health law, we are frequently called upon to provide strategic business and policy advice to clients.