Understanding the business of healthcare
Cox Smith understands not only the law but the business of healthcare. Whether the client is a hospital or a provider organization, a producer of pharmaceuticals or of medical devices, or a retailer of healthcare products and services or a healthcare professional, virtually every practice group in our firm is positioned to provide focused guidance to meet our clients’ sophisticated operational needs. That includes regulatory, corporate, financing, labor, litigation, intellectual property, restructurings and reorganizations, privacy and real estate concerns. And because we are familiar with the relationships that exist among providers, suppliers, third-party payors and regulators, we can effectively advance our clients’ legal and business interests while meeting the unique requirements of the industry’s changing competitive landscape.

We currently serve as general counsel for hospitals, pharmaceutical, medical device companies, retailers and provider organizations throughout Texas, and are positioned to give broad operational advice as well as specific counseling on issues. We regularly act as full-service outside counsel or in collaboration with their in-house lawyers to assist with complex legal issues. With a comprehensive understanding of both healthcare regulation and risk management, we help pursue their business strategies in ways that bring about compliance and minimize the risk of litigation and regulatory action.

Business & transactional matters
We help hospitals, physician practices, pharmaceutical companies and other healthcare providers with regulatory and transactional matters involved with business combinations and financing needs. Our clients often face unique challenges from complicated statutes and regulations that prohibit or limit certain types of arrangements and transactions. We work to analyze proposed transactions under the applicable statutes and regulations, and to create approaches that do not run afoul of any prohibitions. We are well-versed in the restrictions imposed by the Stark and Anti-kickback laws and can help in avoiding or minimizing the risks inherent in dealing with these far-reaching regulatory schemes. Our lawyers counsel clients on how to guard against and avoid anticompetitive practices such as price-fixing and tying arrangements.

Corporate services
We routinely advise healthcare clients with regard to the choice of legal entity most likely to satisfy their business and legal needs as well as structure innovative affiliations and joint ventures.

Because transactions involving provider organizations, suppliers and retailers are highly complex, we document the necessary operational considerations and see that tax, reimbursement, financing, and information system matters are properly addressed and integrated.

Dispute resolution
In the current regulatory climate, healthcare providers, provider organizations, and industry suppliers are subject to increasing scrutiny. At any time, healthcare organizations face potential civil or criminal prosecution, government regulatory actions, reimbursement disputes, contested contracts, medical staff controversies, malpractice allegations, antitrust problems – and more. With our strong focus on representing hospitals and other healthcare providers, Cox Smith knows how to identify and resolve problems before lawsuits or regulatory sanctions are initiated.

We undertake litigation defense for healthcare organizations and handle general business litigation. Our clients get knowledgeable counsel that reflects a thorough understanding of their operations and strategic objectives. We are well situated to handle issues unique to healthcare, such as medical staff relations and reimbursement issues, as well as more broad-based matters such as contract disputes, patent infringement litigation, bankruptcy and reorganization, and regulatory enforcement actions.

Reimbursement
Cox Smith lawyers excel at helping providers secure reimbursement from third-party payors. For example, we often assist providers in disputes with third-party payors including the Medicare program and frequently represent physician practice groups in seeking reimbursement from health maintenance organizations.

Regulation
We advise healthcare provider executives and boards of directors on their most important compliance responsibilities. Providers also turn to us for guidance on credentialing and staff relations concerns. An important part of our fiduciary guidance involves help with the specific requirements of healthcare regulators, as our strong presence in Austin provides a basis for dealing with such state agencies as the Department of State Health Services, the Department of Aging and Disability Services, the Texas Medical Board and the Texas Health and Human Services Commission.

RAC Audits
RAC Audits have become a permanent part of the Medicare program and now, more than ever, providers need to have reliable processes and controls to minimize their risk of financial loss. Cox Smith lawyers are ready to answer questions and provide strategic counsel in developing and implementing procedures to respond to RAC audits and repayment demands. Our lawyers will:

• Assist in responding to the request for records
• Participate in the preparation of responses to allegations
• Prosecute appeals of any repayment demands

Read more about RAC Audits here.

Patient privacy
Cox Smith helps hospitals, nursing homes, insurers and employers with their ongoing responsibilities under the Health Insurance Portability and Accountability Act (HIPAA), HITECH, and state privacy and confidentiality laws. We also help evaluate the effectiveness of compliance efforts, and offer proactive advice and training on privacy compliance. Our lawyers help clients assess their current privacy and security practices, determine potential problems, and create consistent, understandable guidelines for managing information use and disclosure.

Given the major concern for the security of data connected with employee benefit determinations, we provide the added benefit of advice from Cox Smith's benefits and labor and employment groups. Insurers, third-party administrators, information technology providers – even cleaning service contractors – all must be compliant. We give direction on business associate agreements as well as the requirements and responsibilities for proper handling and security of protected health information.

Bankruptcy
A bankruptcy case for a healthcare entity, regardless of the size of the facility, presents multiple unique and complex issues. Cox Smith understands that a healthcare entity facing restructuring and reorganization requires a multi-faceted, multi-disciplinary approach. Thus, utilize lawyers with varying skills to address issues relating to the bankruptcy proceedings itself, as well as patient care, reimbursement, licensing, labor, tax, employment, acquisition and corporate oversight issues. Whether the decision is to reorganize with or without a court proceeding, we have the background to guide the healthcare entity through the entire process so that it can remain focused on its primary mission - providing quality healthcare to patients or residents.

Life sciences
Cox Smith lawyers serve as legal and business counselors to medical device, biotechnology and pharmaceutical companies, as well as major research universities. Equally important, we draw upon the skills of our firm in such areas as intellectual property, corporate and securities and tax to provide comprehensive guidance to emerging and established life sciences companies at every stage of their growth and development. Using the full resources of our firm, we can help life sciences clients with private and public financings, mergers, acquisitions, divestitures, strategic partnerships and joint ventures.

Tax-exempt organizations
Not-for-profit healthcare providers depend on Cox Smith to help preserve the 501(c)(3) tax exemption that is crucial to all their business operations. Should state taxing authorities seek to use a merger or acquisition as an opportunity to reassess property and sales tax exemptions, our experience in dealing with senior state and local tax administrators and authorities can often help achieve continuity of tax-exempt status. We also give tax-exempt organizations guidance in structuring physician recruitment packages in order to avoid private inurement or impermissible private benefit sanctions.

Public law
Cox Smith lawyers have experience in advising governmental entities such as local and regional hospital districts as well as community mental health and mental retardation centers. Our public law insight enables us to assist with legal issues unique to the public sector such as open meetings and public information-related concerns. We also assist with bond issuances and other financing mechanisms.