Overview
Rick helps healthcare professionals, organizations and advisers structure their operations and arrangements to address legal, compliance and business challenges while advancing and protecting their interests.
Rick focuses his practice on healthcare regulatory, data privacy, cybersecurity, corporate, and transactional matters. Rick represents physicians and other healthcare providers and organizations in structuring group practices, joint ventures, ambulatory surgery centers, provider networks, and physician / hospital affiliations, as well as arrangements to provide professional and ancillary services, telehealth, chronic care management, remote patient monitoring, and physician in-office dispensing. His services extend to various corporate and transactional matters, including practice acquisitions and managed care, billing, management, compensation, employment, independent contractor, and other service arrangements.
Rick assists healthcare providers and businesses in developing and implementing proactive approaches to identify and address existing and potential compliance challenges.
He counsels clients on regulatory, fraud and abuse, data privacy and cybersecurity, reimbursement and professional practice issues, including compliance with the Stark physician self-referral law, state self-referral laws, federal and state anti-kickback laws, and corporate practice and fee-splitting restrictions.
Rick provides guidance with respect to the HIPAA Privacy and Security Rules and the HITECH Breach Notification Rule, working with HIPAA covered entities and business associates to implement and update policies, procedures and related safeguards for the privacy and security of protected health information (PHI).
Rick also assists covered entities and business associates in assessing whether a data breach occurred and in reporting and responding to breaches of PHI and in responding to HIPAA investigations and enforcement activities.
Rick earned a J.D., cum laude, from University of Michigan Law School in 1986. He received a B.A., with honors, from Northwestern University in 1981.
Representative Cases & Matters
Corporate
- Outside general counsel representation of physician, dental, chiropractic and optometric practices and federally qualified health centers (FQHCs), with particular focus on:
- Drafting and negotiating contracts and organizational documents
- Counseling on compliance, regulatory, fraud and abuse, employment, privacy, security and reimbursement issues
- Advise physician-owned and physician/hospital-owned ambulatory surgery centers (ASCs) on issues relating to operating and shareholder agreements, issuance and sale of membership interests, and related anti-kickback issues
Structuring Employment and Professional Practice Arrangements
- Represent physician practices in drafting and negotiating pathology, radiology, emergency, anesthesia, neuromonitoring and other professional services agreements with healthcare facilities and providers
- Represent medical practices, physicians, FQHCs and other healthcare providers in preparing and negotiating employment and independent contractor agreements
- Illinois counsel for multi-state surveys and transactions
- Advise and represent physicians and physician practices on affiliations with health systems
- Advise physician networks on corporate, compliance, antitrust and reimbursement matters
- Structure and advise pathology groups regarding joint venture, professional service and laboratory medical director arrangements
- Advise physician super groups regarding fraud and abuse, regulatory, payment, corporate, strategic business unit and transactional issues
Digital Health, Care Management and Remote Patient Monitoring
- Advise physician practices, vendors and care management companies regarding telehealth, remote physiologic monitoring (RPM), remote therapeutic monitoring (RPM), chronic care management (CCM) and remote prescribing legal, regulatory, payment and affiliation issues
- Structure digital health arrangements between healthcare providers and care management companies
- Represent care management and related companies in structuring and negotiating CCM, RPM and RTM staffing and service arrangements with physician practices and FQHCs
- Develop and refine CCM, RPM and RTM policies and procedures
- Analyze and address Medicare, payor, legal and professional standards for CCM, RPM, RTM and telehealth services
Healthcare M&A and Joint Ventures
- Advise healthcare professionals and practices, management companies and investors regarding mergers and acquisitions (M&A), affiliation, joint venture, practice management and related opportunities and transactions
- Structure and negotiate:
- agreements for sale or acquisition of professional practice assets and ownership interests
- M&A transactions and joint ventures
- management, business support and related financial arrangements for investor and management company involvement in medical, dental and behavioral health professional practices
- practice integration of physicians, dentists and other healthcare professionals
- management service agreements for physician in-office prescription drug dispensing arrangements
- Advise on regulatory, compliance, data privacy, reimbursement, fraud and abuse and related due diligence issues in connection with M&A, joint ventures and management agreements
- Analyze and advise on regulatory due diligence
- M&A and joint venture practice areas include pathology, primary care, dermatology, ENT, audiology, behavioral health, neuromonitoring, orthopaedics, spine, ambulatory surgery centers, sleep labs, pulmonary, dental, plastic surgery and medspas
Payment/Reimbursement
- Advise healthcare providers on surprise billing restrictions, obligations and procedures
- Advise and represent healthcare providers on reimbursement self-audits, overpayment reporting and payor audits
- Advise healthcare providers on anti-markup rule
- Advise physicians and physician organizations on value-based payment models
- Advise physicians and management companies on direct primary care and concierge medicine models
Compliance, Fraud and Abuse
- Advise healthcare organizations and professionals on fraud and abuse issues, including compliance with the Stark self-referral law, state self-referral laws, federal and state anti-kickback statutes and overpayment obligations
- Advise ambulatory surgery centers (ASCs) on anti-kickback and self-referral issues relating to physician ownership and defend ASC against fraud and abuse allegations
- Advise physicians and healthcare organizations on compliance programs and issues
HIPAA, Data Privacy and Security
- Draft and negotiate HIPAA business associate agreements
- Represent HIPAA covered entities and business associates in the review, development and implementation of HIPAA policies and procedures
- Advise covered entities and business associates on risk assessment and breach reporting
- Advise covered entities and business associates regarding de-identification of PHI and use, sharing and disclosure of de-identified information
- Draft and negotiate data use agreements
- Advise covered entities and business associates on 42 CFR Part 2 (substance use disorder information)