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Gjerset & Lorenz, LLP assists hospitals and other healthcare organizations with a broad spectrum of operational issues.  For some clients we serve as outside general counsel and for other clients we address individual operations issues as they arise.  Whether our clients have day-to-day questions or face complex regulatory challenges, our attorneys bring in-depth experience in healthcare law covering every corner of provider operations.

Licensing, Credentialing, and Accreditation

Gjerset & Lorenz represents hospitals, nursing homes, psychiatric hospitals, medical groups and individual practitioners in all aspects of provider licensing, credentialing and accreditation. Multiple agencies and organizations issue licenses, credentials, and accreditations for healthcare providers. With our experience in the health law field, Gjerset & Lorenz has developed comprehensive knowledge of the steps necessary to guide our clients through these licensing, credentialing, and accreditation bodies and their requirements.

We provided counsel to providers in a variety of state and federal licensing contexts, representing them before the Centers for Medicare and Medicaid Services, state health departments, and the Joint Commission.

Provider Policies and Executive Education

Gjerset & Lorenz has significant experience advising clients related to the compliance considerations of both their day-to-day operations and specific business decisions.  We assist providers to ensure they meet their business goals while complying with the myriad of regulations applicable to the healthcare industry, including as examples the Emergency Medical & Labor Treatment Act, the Health Insurance Portability and Accountability Act, charity care regulations, prompt payment requirements, and government program conditions of participation.  Gjerset & Lorenz also assisted providers to evaluate, design and implement compliance policies that balance legal requirements with best practices and cost efficiency goals.  We educate executive teams and help them implement these policies nationwide, taking into account the individual needs of each facility. 

Formation and Operation of Corporate Entities

We assist providers to form and operate new business entities to achieve their operational objectives.  This process involves evaluating the appropriate business structure for the entity based on the client’s goals, structuring the entity to achieve these goals, and then drafting the necessary formation documents (e.g. Articles of Incorporation, Bylaws, resolutions and policies). Operation of these entities includes maintaining the entity’s governing documents, applying for tax-exempt status, obtaining and retaining certification with necessary state/federal agencies (e.g. state medical boards) and ensuring the entity’s compliance with state corporate law requirements, private inurement limitations, and other state and federal law. 

Contract Drafting & Negotiation

Contract negotiations are not only a part of business transactions between healthcare entities; they are also a key part of how an individual hospital or hospital organization conducts business. The legal team at Gjerset & Lorenz applies their knowledge of complex federal, state, and local laws, as well as the nuances of the industry, to negotiate, draft and interpret contracts in areas including:

  • Contracts for payment of providers, including:
    • Contracts with federal, state and local governmental entities related to a provider’s participation in a governmental reimbursement program;
    • Contracts with federal, state and local governmental entities for reimbursement related to a specific patient population; and
    • Contracts with private entities for reimbursement of services provided under governmental or privates programs. 
  • Physician-hospital contracts, including:
    • Employment agreements;
    • Professional services agreements;
    • Directorship agreements;
    • Relocation and recruitment agreements;
    • Management services agreements;
    • Research agreements; and
    • Fellowship agreements.
  • Provider services contracts, including contracts with laboratories, medical transport providers, imaging centers, pharmaceutical providers, clinical trials providers, behavioral healthcare providers, ambulance providers and other third parties.
  • Joint-venture or affiliation contracts memorializing collaborations between providers or with providers and third-party governmental and private entities.

A substantial number of these contracts involve physicians or physician groups. Our attorneys have considerable experience in analyzing and structuring such arrangements to comply with self-referral, anti-kickback, corporate practice of medicine, licensing, and other regulatory concerns while simultaneously maintaining the structure and rationale for the deal.

Additional Services

Gjerset & Lorenz also advises clients on a wide range of other provider operations issues including:

  • Peer Review;
  • Quality Assurance;
  • Risk Management;
  • Private Inurement;
  • Charity Care;
  • Bad-Debt Collection;
  • Fraud and Abuse Compliance;
  • Patient Rights;
  • Admission and Discharge Requirements;
  • Patient Transfers; and
  • Confidentiality of Patient Information.