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Health Care Litigation

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Rankings & Honors

  • U.S. News/Best Lawyers has named Nixon Peabody “Law Firm of the Year” in Health Care Law in 2016
  • U.S. News/Best Lawyers “Best Law Firms” ranked as National Tier One in Commercial Litigation, Litigation—First Amendment, Litigation—Labor & Employment and Mass Tort Litigation/Class Actions—Defendants. Received Tier One Metropolitan Honors in Appellate Practice, Commercial Litigation, Criminal Defense: White Collar, Litigation—Banking & Finance, Litigation—Bankruptcy, Litigation—First Amendment, Litigation—Labor & Employment, Litigation—Securities, Litigation—Tax, Mass Tort Litigation/Class Actions—Defendants, and Product Liability Litigation—Defendants in numerous cities throughout the U.S.
  • BTI Litigation Outlook 2016
  • Chambers USA/Global
  • Legal 500
  • Benchmark: Litigation/Appellate
 

HEALTH CARE LITIGATION

We provide cost efficient and innovative representation to minimize institutional risk and disruption allowing focus to remain on patient care. We combine our trial-tested litigation and dispute resolution skills with deep industry knowledge.

Our approach

Health care is among the fastest growing industries in the U.S., and while advancements in treatments create new opportunities every day, growth does not come without challenges—economic stresses, increased scrutiny and government regulation have increased the risks facing health care providers.

Failure to navigate the risks properly can result in disruptive disputes and litigation. We understand the challenges faced by businesses in the regulated health care industry. And we know how to get clients back to business fast.

Our efficiency, knowledge of the industry and litigation experience are particularly valuable to clients who need appropriate and cost-efficient litigation results.

We assist clients with litigation involving many different aspects of health care at the local, state and national levels, including:

  • Medical staff issues
  • Privacy
  • qui tam claims
  • Medicare and Medicaid reimbursement
  • Managed care contracts
  • Certificates of need
  • Graduate medical education programs
  • Antitrust litigation
  • Enforcement or defense of restrictive covenants
  • Health Insurance Portability and Accountability Act (HIPAA) regulations

Who we work with

  • Hospitals and hospital networks, clinics and nursing homes
  • Physicians and home care providers
  • Fiscal intermediaries and insurers
  • Managed care organizations
  • Pharmaceutical firms

Recent experience

Class Actions
  • Representing hospital as coordinating counsel in the criminal, regulatory and civil actions arising from the infection of patients with Hepatitis-C, allegedly by a former employee. Obtained favorable ruling denying class certification for two proposed classes as lead defense counsel in a putative class action brought by a plaintiff who claimed to be one of 32 patients infected while undergoing medical procedures at the hospital.
  • Defending large hospital systems in a putative class action brought by current and/or former employees. The complaint alleges numerous causes of action, including but not limited to FLSA and RICO violations, violations of New York labor law, breach of contract, breach of fiduciary duty pursuant to ERISA and fraud.
  • Defending a rehabilitation center against claims initiated by a patient with dual diagnoses of mental health and traumatic brain injury, was expatriated to a facility outside of New York State because of an alleged inability of New York agencies to appropriately facilitate dual services.
  • Represented numerous hospital defendants in class action in New York State Supreme Court pertaining to allegedly excessive charges imposed for medical records copying.
  • Obtained favorable settlement for primary care, rehabilitation and senior services hospital network in an antitrust class action alleging price-fixing by hospitals in setting nurses compensation.
  • Obtained defense verdict for a regional health care organization after a seven-day jury trial regarding allegations of race and national origin discrimination, retaliation and deprivation of due process brought by a former general surgery resident who was not promoted.
Medicaid Reimbursement
  • Secured preliminary injunction as lead counsel for 10 hospital clients who sued the state of New Hampshire over more than $260 million in improper Medicaid reimbursement cuts
  • Representing New York-based nursing home in administrative litigation regarding significant Medicaid reimbursement issues; secured favorable determination of Administrative Law Judge
Health Care Facilities Construction-Related Disputes
  • Obtained successful settlement for large gastroenterology practice in mediation of claims against designer/builder for lost profits arising from failure of flooring system in ambulatory care center and medical offices built without requisite vapor barrier.
  • Representing a New York-based hospital in a lawsuit against its architect claiming negligence, professional malpractice and breach of contract after the architect’s design failed to conform with state and local building and life safety codes, resulting in costly delays and errors in the construction of the hospital’s expansion project.
Medical Staff Disputes
  • Secured landmark ruling for senior care facility and hospital in a medical staff dispute, where the New York Court of Appeals held that medical staff bylaws do not support a claim for breach of contract and damages.
  • Representing hospital in a lawsuit by a physician who raised allegations of intentional interference with prospective business advantage, violations of New York’s Human Rights Laws, civil conspiracy and defamation after his privileges were terminated following his departure.
  • Obtained favorable settlement for hospital and hospital network in breach of contract and unfair competition and fraud claims by an emergency room physician and his professional corporation in connection with the termination of an exclusive services agreement the physician practice had with the hospital.
Commercial Litigation
  • Secured dismissal of claims against a New York-based teaching hospital and its directors in an action brought by a relative of a deceased donor, who alleged that the terms of her relative’s charitable bequest to the resident nursing school had not been followed over the preceding decades. The Second Circuit upheld the decision.
  • Secured a defense verdict for a New York medical center in five of six claims brought by the operator of an adult home. Rejected claims included a demand for both compensatory and punitive damages, alleging the hospital destroyed the business while acting as temporary operator of the adult home at the request of the New York State Department of Health. The hospital is appealing the remaining conversion claim.
Administrative Hearings
  • We have handled a variety of administrative matters for our provider clients, including claims and appeals for Medicaid reimbursement, challenges to Medicaid audit findings, administrative appeals before state departments of health, Medicaid “Fair Hearings,” licensure appeals and judicial appeals of adverse administrative determinations (including Article 78 proceedings in New York State).
Graduate Medical Education
  • We have represented numerous academic medical centers and teaching hospitals in connection with litigation concerning graduate medical education, including actions to challenge administrative sanctions imposed on medical residency programs and the defense of actions brought by aggrieved medical residents.
Guardianship Proceedings
  • We have represented numerous health care providers in guardianship proceedings seeking court appointment or removal of guardians for patients or consumers.
Retention Hearings
  • We have represented medical center psychiatric departments in connection with proceedings commenced either by the hospital department or by the mentally ill patients they treat, who are in turn represented by Mental Hygiene Legal Services. While we handle all types of issues arising from retention hearings, we have particular experience representing clients in Due Process hearings held under New York’s Mental Hygiene Law, specifically involuntary retention, medication over the patient’s objection and assisted outpatient treatment.
Restoration Hearings
  • We have represented doctors, nurses and other licensed professionals before the Department of Education in connection with proceedings to restore a professional license. The restoration process is multi-faceted, and we have assisted professionals in filing applications, commencing and prosecuting an evidentiary hearing and presenting the case for restoration before the commission.

Media Clips

  • Will NY Expand the Scope of Providers' Duty of Care?
    Law360 | May 19, 2015
    Albany Health Care partner Laurie Cohen and Albany Commercial Litigation associate Jena Rotheim coauthored this article on whether New York’s state’s highest court is willing to significantly expand the scope of individuals to whom medical providers owe a duty.
  • Patients Get Direct Access to Lab Reports
    Clinical Laboratory News | April 1, 2014
    Partner and leader of the firm’s Privacy & Data Protection practice Linn Freedman discusses how labs should comply with patient requests for records under a new rule issued by the Department of Health and Human Services.
  • People on the Move
    Albany Business Review | March 11, 2014
    This coverage notes that Albany Commercial Litigation partner Dan Hurteau has been elected to the Rensselaer County Regional Chamber of Commerce Board of Directors.
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  • Sisters of Charity of Leavenworth Health System and St. James Healthcare Agree to Pay $3.85 Million to Resolve Fraud and Abuse Allegations
    American Health Lawyers Association | January 6, 2014
    Boston Government Investigations & White Collar Defense partner Brian French discusses the implications of the agreement between the U.S. Department of Justice (DOJ) and St. James Healthcare and its parent company, Sisters of Charity of Leavenworth Health System, to pay nearly $4 million to resolve alleged violations of the Anti-Kickback Statute, the Stark Law, and the False Claims Act.
  • 2013's Game-Changing Health Rulings
    Law360 | December 17, 2013

    Boston Government Investigations & White Collar Defense partner and a member of the firm’s Life Sciences practice Brian French discusses high-stakes cases for the health industry including those involving False Claims Act litigation and reimbursement disputes.

Ideas

U.S. District Court finds nursing home pre-dispute arbitration agreements lawful
Health Care Alert | November 17, 2016

Health care data breach case highlights risk to companies for unauthorized use of data by employees
Health Care Alert | May 13, 2016

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Fourth Circuit: insurer has obligation to provide defense under CGL policy to data breach claim
Health Care Litigation Alert | April 25, 2016

California hospital settles data breach case with largest per plaintiff payout in history
Health Care Alert | March 28, 2016

Government's stepped-up focus on Medicare fraud in home health care: learning from recent criminal prosecutions
Health Care Alert | February 1, 2016

New York's highest court expands medical providers' duty of care
Health Care Alert | January 8, 2016

The Supreme Court will review False Claims Act circuit split regarding what counts as a "false" claim for payment
Government Investigations & White Collar Defense Alert | December 9, 2015

New York physicians prevail in suit alleging "surprise" bills
Health Care Alert | October 23, 2015

Fourth Circuit upholds $237 million judgment against Tuomey Healthcare System
Health Care Alert | July 14, 2015

Will the New York Court of Appeals expand the class of individuals to whom providers owe a duty of care?
Health Care Alert | April 24, 2015

Webinar Recording: Tech Talk 101: are you fluent in the language of data security?
Originally recorded October 8, 2014 | October 14, 2014

Court upholds unwinding yet another health care merger
Antitrust Alert | April 30, 2014

Federal court keeps stem cell products under FDA's rule
Pharmaceutical, Medical Device And Life Sciences Alert | February 11, 2014

NY State's highest court finds health care clinic is not liable for nurse's disclosure of patient information
Health Alert | January 13, 2014

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Health Care Litigation