Buchalter’s Health Systems & Hospitals Industry Group provides comprehensive legal counsel to all types of hospitals, health systems, and academic medical centers on operational, transactional, and regulatory issues impacting their organizations. Our attorneys combine deep industry knowledge with extensive experience representing health care providers in both litigation and advisory matters.
We regularly represent hospitals and health systems in a wide range of managed care litigation involving commercial and Medicare/Medicaid managed care plans. We represent our clients in out-of-network disputes involving establishing the reasonable value of emergency services, and in in-network disputes enforcing providers’ contractual right to payment, including addressing improper medical necessity and coding denials, and challenging other tactics that payors use to unfairly delay or deny payment on claims. We also handle matters involving overpayment and allegations of fraud and abuse. Our team routinely and successfully handles matters against all major commercial health plans and government payors in arbitration and litigation forums nationwide.
Our attorneys also advise clients on provider contracting, assisting with the negotiation, drafting, and implementation of agreements with payors, physicians, and other health care entities. We help structure relationships that support operational objectives while maintaining compliance with federal and state regulatory requirements.
In addition, we counsel clients on regulatory compliance and fraud and abuse matters, including issues arising under the Stark Law, Anti-Kickback Statute, False Claims Act, and related state laws. Our experience includes advising on compliance program development, internal investigations, voluntary disclosures, and responses to government inquiries.
Buchalter’s Health Systems & Hospitals team is dedicated to providing practical, business-oriented solutions that help our clients navigate complex legal and regulatory landscapes while advancing their mission to deliver high-quality patient care.
