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)
Honors & Recognition
Recognized by Leading Lawyers for his work in the areas of Closely & Privately Held Business Law and Health Law (2022)
Credentials
Education
University of Michigan Law School
Northwestern University
Admissions – State
- Illinois
- Pennsylvania
Professional & Civic
Professional Activities
Illinois Association of Healthcare Attorneys (President, 2022; 2021 Symposium Chair; Board of Directors, 2016-present)
Partnership For a Connected Illinois (PCI) (Board of Directors, 2021-present); PCI’s Illinois Telehealth Initiative Program Planning Committee (cochair, 2022-present, participating committee member, 2017-present)
Chicago Health Executives Forum (CHEF) – Education & Networking Committee (2016-present)
American Health Law Association (AHLA) Physicians and Hospitals Law Institute Program Planning Committee, 2017-2022; Physician Organizations Practice Group Vice Chair, 2010-2016
Illinois State Bar Association (Privacy & Information Security Law Section Council, 2019-present; Health Care Section Council, 2005-2014, Chair 2012-2013)
News & Insights
External News & Publications
Quoted, "CMS: RPM’s PHE Flexibilities Don’t Extend to RTM; Number of Days Required Is Still Iffy," Report on Medicare Compliance, February 2022
Coauthor, “Physician Practice Acquisitions and Affiliations” chapter, Health Care Transactions Manual (2020)
Coauthor, “Successfully Designing and Implementing a Code of Conduct,” AHLA Connections, November 2019
Coauthor, "HIPAA Wake-up Call," Medical Group Management Association, MGMA Connection, July 2018
Author, “Physician Reimbursement and Billing” chapter, The Law of Medical Practice in Illinois (2018 edition)
Coauthor, "Medical Records Issues in the Transfer or Closing of a Medical Practice: Address Them Upfront to Avoid Problems Later," AHLA Connections, March 2018
Author, “Illinois Implements Licensing Process for Psychologist Prescribing,” American Health Lawyers Association PG briefing, January 2018
Project Leader, “Telemedicine: What it is and How it May Affect You,” American Health Lawyers Association Public Interest Series, January 2017
Project Leader, “How Does This Work? Using Mobile Health Technology While Protecting Your Privacy,” American Health Lawyers Association Public Interest Series, September 2016
"CMS Expands Medicare Payment for Chronic Care Management and Behavioral Health Care Services," Physician Organizations, May 2017
Coauthor, "OCR Enforcement Action Sends Clear Message to Covered Entities: Timeliness Matters When It Comes to Breach Notification," AHLA Practice Group Alert, January 2017
Quoted, "Paradigm Shift: Don't Expect a Small Penalty for a Small Breach," Health Information Compliance Alert, July 2016
Author, "Physician ancillary services" chapter, Representing Physicians Handbook, 4th Edition
Coauthor, "Physician in-office drug dispensing and compounding arrangements" chapter, Representing Physicians Handbook, 4th Edition
Coauthor, "NIST/OCR Security Conference Reemphasizes Importance of Robust Security," American Health Lawyers Association, October 27, 2015
Coauthor, "HIPAA Settlements Focus on Encryption and Risk Analysis," American Health Lawyers Association, October 26, 2015
Coeditor, "Analysis of Key Provisions Contained in the 2016 Medicare Physician Fee Schedule Proposed Rule," American Health Lawyers Association Member Briefing, August 2015
Coeditor, "Toolkit: Corporate Practice of Medicine & Free Splitting Issues," Illinois Association of Healthcare Attorneys, May 2015
"Protecting data and escalating enforcement in the US," eHealth Law and Policy, May 2015
Quoted, "Cyber Criminals Want Your Data: Protect Your Patients and Your Lab," g2reports, April 28, 2015
"Hospital Employment of Physicians: Diagnosing the Risks," Journal of Corporate Renewal, April 2015
Quoted, “Watch for Overpayments as Final Rule Delay Leaves Providers Vulnerable Under FCA,” Part B News, March 2, 2015
Coauthor, “Medicare Chronic Care Management,” Medical Home News, March 2015
Quoted, "12 Changes That Will Affect Doctors’ Income in 2015," The Direct Primary Care Journal, February 15, 2015
“Proposed Rule Would Ease ACO Exclusivity Restrictions for Some Physician Specialties,” AHLA Executive Summary, February 2015
“Navigating HIPAA and Cybersecurity in the Cloud,” Northern Ohio Physician, January/February 2015
Contributor, "Physician Reimbursement for Chronic Care Management: Identifying New Practice Revenue Opportunities," Healthcare Intelligence Network, January 2015
Coauthor, “Private Payor and Physician Perspectives on ACO Collaborations” chapter, The ACO Handbook (2015)
Quoted, "CMS Chronic Care Management Medicare Reimbursement: Sizeable Revenue, Health Outcome Opportunities," Healthcare Intelligence Network, November 21, 2014
Quoted, "Protect your practice; insist on a BAA from your online appointment vendor," Part B News, October 13, 2014
Quoted, "To avoid penalties, go beyond HHS’ HIPAA security risk analysis tool," Part B News, April 21, 2014
“ACO Physician Exclusivity: Principles and Alternatives,” AHLA Executive Summary, March 2014
“New Settlement Another Reminder of HIPAA Exposure for Physician Practices,” AHLA e-alert, December 2013
“Physician In-Office Prescription Drug Dispensing,” AHLA Physician Organizations Newsletter, December 2013
"CMS Issues 2014 Medicare Physician Fee Schedule Final Rule," RBMA Monthly Legal Update Digest December 2013
"CMS Issues 2014 Medicare Physician Fee Schedule Final Rule," McDonald Hopkins LLC Alert, December 2013
Quoted, "Are your business associate agreements up-to-date with the latest HIPAA requirements?" Medical Office Manager, November/December 2013
"Business Associates" chapter (co-author), HIPAA Revisited: An Analysis of the Omnibus Rule and a Practical Compliance Guide (American Health Lawyers Association Member Briefing), November 2013
"Who is a HIPAA Business Associate?," RBMA Monthly Legal Update Digest July 2013
“ACOs and Physicians Face Challenges in Navigating Physician Exclusivity Restrictions,” Accountable Care News, June 2013
"CMS Issues Guidance on ACO Physician Exclusivity," RBMA Monthly Legal Update Digest May 2013
“CMS Issues FAQ Guidance on ACO Physician Exclusivity,” American Health Lawyers Association, April 2013
“HITECH Final Rule Revises Privacy, Security and Breach Notification Rules,” (coauthor), Northern Ohio Physician, March/April 2013
"Physician Payment Sunshine Act Final Rule Issued: Manufacturers and GPOs to Report Financial Relationships with Physicians," RBMA Monthly Legal Update Digest March 2013
"Final Rule Implements HITECH Revisions to Privacy and Security Rules," RBMA Monthly Legal Update Digest February 2013
“Diagnostic Testing Toolkit,” American Health Lawyers Association, 2012 (editor)
"Can Specialist Physicians Participate in More than One ACO?" RBMA Monthly Legal Update Digest November 2012
"Physicians Participating in ACOs May Be More Exclusive Than They Think," RBMA Monthly Legal Update Digest October 2012
"Compliance Plans for Physician Practices," American Health Lawyers Association, August 2012 (coeditor)
“Accountable Care Organization Member Briefing,” American Health Lawyers Association, May 2012 (contributing author)
“MedPAC calls for Physician Reimbursement Changes,” and “New Commission to Recommend Changes to Physician Payment System,” American Health Lawyers Association Physician Organizations Monthly e-Newsletter, April 2012
"Physician supervision and scope of practice issues can create liability," RBMA Monthly Legal Update Digest February 2012
“CMS Regulations Expand Enrollment Screening Procedures and Authority to Suspend Payment,” RBMA Monthly Legal Update Digest May 2011
“Registration Required for Illinois Medical and Professional Limited Liability Companies,” RBMA Monthly Legal Update Digest May 2011
“Stark Law Disclosure Requirement for MRI, CT and PET Tests,” RBMA Monthly Legal Update Digest May 2011
“Medical Control of Emergency Medical Services,” Journal of Health & Life Sciences Law, February 2011 (coauthor)
“CMS Regulations Expand Enrollment Screening Procedures and Authority to Suspend Payment,” American Health Lawyers Association Physician Organizations Monthly e-Newsletter, February 2011 (coauthor)
“Survey of Illinois Law: Health Care,” 34 Southern Illinois University Law Journal 1033, 2010 (coauthor)
“OCR Proposes to Extend HIPAA Obligations to Subcontractors of Business Associates, Implement HITECH Provisions,” G-2 Compliance Report, September, 2010
“Office of Civil Rights Issues Proposed HITECH Rules,” American Health Lawyers Association Practice Group email Alert, July 16, 2010 (coauthor)
“CMS Updates Signature Guidelines,” Physician Organizations Practice Group e-Newsletter, May, 2010
“Ambulances, Emergency Medical Services and Medical Transportation,” chapter, Health Law Practice Guide, American Health Lawyers Association (coauthor)
“Physician Ancillary Services” chapter, Representing Physicians Handbook, 2nd edition (2009)
“Illinois Medical Fee Splitting Statute Amended to Allow Percentage Billing Contracts,” Health Care Lawyer, December, 2009 (Volume 26, No. 2)
"UnitedHealth Group and Aetna Agree to Settlements of Out-of-Network Reimbursement Rates," Northern Ohio Physician, March/April 2009
“In-Office Diagnostic Testing: 2009 Medicare Physician Fee Schedule Revises Standards,” Physician Organizations Newsletter, March 2009 (Volume 12, Issue 1) (coauthor)
“2009 Medicare Physician Fee Schedule Revises Anti-Markup Rule,” Diagnostic Imaging Intelligence, January 2009 (coauthor)
"Enforcement Activities and Litigation Target Low Out-of-Network Reimbursement Rates," Northern Ohio Physician, November/December 2008
"Survey of Illinois Law: Health Care,” Southern Illinois University Law Journal, Summer 2008 (Volume 32) (coauthor)
“Impact of Anti-Markup and IDTF Sharing Restrictions Upon Physician Provision of Diagnostic Tests,” Physician Organizations Newsletter, February 2008 (Volume 11, Issue 1) (coauthor)
"Physician Reimbursement and Billing," chapter, The Law of Medical Practice In Illinois, 3rd edition (2007, along with 2008-2011 updates)
Vine Street's Impact on PPO/Doctor Business Arrangements," Illinois Bar Journal, July 2007 (coauthor)
"Illinois Supreme Court Upholds Physician Restrictive Covenants," Health Care Lawyer, March 2007 (Volume 23, No. 3)
"Workers' Compensation Changes for Health Care Providers," Health Care Lawyer, September 2006 (Volume 23, No. 1)
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Events
Speaking Engagements
Speaker, “Health Care Law and Regulatory Overview,” March 8, 2022
Speaker, “Remote Patient Monitoring: Contract Structures, Medicare Coverage, and Regulatory Compliance,” February 1, 2022
Moderator, “Evolving Privacy Issues in Telehealth and Genetics," September 23, 2021
Moderator, “Emerging Digital Health Players & Healthcare Delivery Models,” September 15, 2022
Speaker, “Health Care Law and Regulatory Overview,” January 26, 2021 (virtual presentation)
Speaker, “Stark and Anti-Kickback Final Rules: Implications For Physicians and Physician Practices,” January 12, 2021 (virtual presentation)
Speaker, “Stark Law and Anti-Kickback Final Rules: Challenges and Opportunities for Physician Practices,” January 7, 2021 (virtual presentation)
Speaker, “Negotiating Physician Employment Agreements: Key Principles and Issues for Medical Employers and Physician Employees,” Illinois State Medical Society on-demand webinar (2020) https://www.mymeded.com/illinois-state-medical-society/content/negotiating-physician-employment-agreements-key-principles#group-tabs-node-course-default1
Speaker, Privacy and Security Risks Related to the COVID-19 Pandemic, August 11, 2020
Speaker, Key Compliance Considerations in Structuring Health Care Transactions and Relationships, July 16, 2020
Speaker, “Privacy and security risks for providers related to COVID19 pandemic,” Tuesday, June 9, 2020
Moderator, “Telehealth opportunities and challenges for physician practices during the COVID-19 emergency and beyond,” June 2, 2020
Speaker, “Designing and Implementing a Health Care Code of Conduct under OIG and Department of Justice Guidance,” April 28, 2020
Speaker, “Structuring Indemnification Provisions in Business Associate Agreements: Allocating Risk in Healthcare Contracting,” December 4, 2019
Moderator, “Telehealth: Key Adoption Factors, Barriers and Opportunities,” 2019 First Illinois HFMA Fall Summit, October 22, 2019
Panelist, "Remote Patient Monitoring Reimbursement," 2019 Illinois Telehealth Law & Policy Forum, Thursday, September 5, 2019
Speaker, Health Industry Cybersecurity Best Practices, February 28, 2019
Moderator, Chronic Care Management and Remote Patient Monitoring: Reimbursement, Innovation and Potential, Thursday, September 20, 2018
Presenter, "Medical Practice Transfers and Closings: Addressing Medical Records Issues," July 18, 2018
Facilitator, "Roundtable Discussions: Current Areas of Concern for Life Science Corporations, Stark Law," June 6, 2018
Presenter, "Chronic Care Management," May 22, 2018
Moderator, "Hospital/Physician Relationships in 2018 and Beyond: Winding Pathways, Deeper Potholes and Deceiving Guideposts," May 17, 2018
Presenter, "Managing HIPAA Business Associate Relationships," Tuesday, April 24, 2018
Presenter, “Ancillary Services: Just What the Doctor Ordered or Quagmire for Physician Practices,” February 5, 2018
Presenter, “Structuring Physician Timeshare Arrangements: Leveraging the Stark Exception, Navigating the Limitations,” October 18, 2017
Presenter, “Challenges Faced by Physician Retirement ,” October 6, 2017
Presenter, Health Care Essentials webcast: HIPAA Privacy and Security, Health Care Compliance Programs, Fraud and Abuse, September 18, 2017
Presenter, "Chronic Care Management Programs and Beyond," Telehealth Law Forum, September 12, 2017
Presenter, "Avoiding an Expensive Mistake: Identifying and Managing HIPAA Business Associate Relationships," August 30, 2017
Presenter, "Advising Boards of Directors, Management and Physician Leaders"; "HIPAA Regulatory Compliance"; "Negotiating Healthcare Contracts", June 24, 2017
Presenter, "The Evolving Intersection of Law and Finance in Health Care: What You Need to Know in the Post ACA World, All Parts," June 12, 2017
Presenter, “Structuring Physician-Pharmacy Ventures: Minimizing Regulatory Risks, Ensuring Reimbursement,” May 3, 2017
Moderator, “Implementing an Effective Compliance Program While Identifying and Overcoming Pervasive Ethical and Privilege Concerns,” November 10, 2016
Presenter, "Traveling the Road to Value-Based Payment in a Regulatory Enforcement Minefield, Part IV," November 15, 2016 (webinar)
Moderator, "Comprehensive Primary Care Plus (CPC+): Implications and Challenges," September 8, 2016 (webinar)
Presenter, "Panel Discussion: HIPAA Compliance for Technology Startups," August 30, 2016
Presenter, “Healthcare Business Law: Changes You Need to Know!”, May 26, 2016 (webcast):
Hot-Button Issues and Current Trends in Health Law
The New HIPAA Compliance Regulations, Requirements and Procedures: an Attorney’s Guide
Board of Director Liability: Legal Responsibilities and Best Practices
Healthcare Contracts: Negotiating and Enforcement
Presenter, “Structuring Physician Timeshare Arrangements: Leveraging the New Stark Exception, Navigating the Limitations,” April 28, 2016
Moderator, “Advanced Compliance Education Webinar Series: Part VII: Compliance for Physician Practices,” February 29, 2016
Presenter, "Structuring Business Associate Agreements for Covered Entities and Business Associates," December 21, 2015
Moderator, "Physician Self-Referral Regulations Revisions: Implications and Challenges," December 16, 2015
Presenter, “Structuring Physician-Pharmacy Ventures: Minimizing Regulatory Risks, Ensuring Reimbursement,” November 19, 2015
Moderator, “Medicare Physician Fee Schedule 2016 Proposed Rule: Important Policy Issues to Consider Now,” August 31, 2015 webinar
Presenter, "Medicare Chronic Care Management: Billing, Compliance, and Implementation Issues," AHLA webinar March 24, 2015
Presenter, “Structuring Physician In-Office Drug Dispensing and Compounding Arrangements,” February 2 and 4, 2015
Presenter, "Lawyers as HIPAA Business Associates," November 21, 2014
Presenter, "Chronic Care Management Medicare Reimbursement: New Revenue Opportunities for Care Coordination," November 19, 2014
Presenter, “Medicare and Reimbursement Issues,” March 31, 2014
Presenter, “Lawyers as HIPAA Business Associates,” October 4, 2013
Webinar panelist, "The new HIPAA standards: Are you ready?" August 22, 2013
Co-presenter, “Protecting Health Data: Changes and Action Steps for Health Plans, Providers and Their Business Associates,” July 25, 2013
Moderator, “Privacy Breach Notification and the New HIPAA/HITECH Regulations,” May 30, 2013
Moderator, “Emerging Health Care Delivery Models,” April 19, 2013
Webinar presenter, “ACO Beneficiary Assignment and Physician Exclusivity,” March 13, 2013
Webinar presenter, “Medicare Payment to Physicians and Others Covered Under Part B,” January 9, 2013
Moderator, “National Healthcare Reform and Its Effect on Illinois Employers and Health Insurance,” November 8, 2012
Presenter, “HIPAA/HITECH Update,” October 18, 2012
Webinar co-presenter, “ACO Emerging Trends – Lessons Learned on ACO Start-Up,” September 14, 2012
Moderator, “National Federation of Independent Business v Sebelius: A Final Decision on Health Care Reform?”
Panelist, "Healthcare Disaster Recovery Planning & HIPAA Security Compliance: Best Practices," Techweek Conference 2012
Webinar moderator, "Physician Supervision Requirements and False Claims Implications for Diagnostic Testing," January 10, 2012
Webinar co-presenter, "HITECH and HIPAA Security Compliance: Critical Issues for Healthcare Organizations, " December 14, 2011
Webinar co-presenter, “HITECH and HIPAA Security Compliance: Critical Issues for Healthcare Organizations,” October 4, 2011
Panelist, "Roundtable Discussion of Recent Issues Affecting Physicians," Physicians and Physician Organizations Law Institute, February 9, 2011
"Structuring Ancillary Revenue Transactions," Physicians and Physician Organizations Law Institute, February 9-10, 2009
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