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M&R’s Health Care Department knows the ins and outs of health care, and fully comprehends the long-term business goals and concerns of the health plans and health care providers we serve. Our attorneys are health care authorities, providing our clients seamless advice on legal and business issues. 

Whether dealing with a health plan and insurer, a hospital, an assisted living facility, a provider, a third-party administrator (TPA), or other health care entities, we apply our intimate knowledge of health care to provide industry-focused expertise that caters to our clients’ needs. 

Our attorneys have an exemplary track record handling the full spectrum of complex health care litigation. We routinely counsel clients through shareholder disputes, payor-provider disputes management company disputes, coding issues, and fraud and abuse.  M&R attorneys have successfully litigated many high-profile cases before state and federal courts, and regularly handle major class actions, having recovered tens of millions of dollars on behalf of our clients.

We also have expertise dealing with the most difficult transactions in addition to regulatory and day-to-day business matters. Our attorneys have represented clients in highly elaborate joint ventures and mergers and acquisitions of health care facilities and hospitals. We have also provided counsel on financing, leasing, entity formation and regulatory issues involving the Stark Law, the Anti-Kickback Statute, the Anti-Markup Rule and the False Claims Act. Additionally, M&R attorneys advise physician groups on issues related to ancillary services such as laboratories and imaging centers, and a wide range of corporate, labor and employment and commercial business issues related to the health care industry.

As an industry-focused firm, we are actively involved with the American Health Lawyers Association, Ambulatory Surgery Center Association, California Association of Health Plans, and California Society for Health Care Attorneys. We are frequently featured as speakers and guest panelists at events hosted by these and other health care organizations, and regularly publish articles in top health care trade publications.

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Areas Of Expertise

Ambulatory Surgery Centers:  M&R has been taking the lead on reorganizing the compensation of Surgeons in Ambulatory Surgery Centers to increase their profit share while successfully helping them navigate the rocks and shoals of the Anti-Kickback laws and the Ambulatory Surgery Safe Harbor attached to those law.

Acquisition: M&R represented the JOPAL Group in the $120 million transfer of physical assets (TPA) of Workmen’s Circle MultiCare Center, a 560-bed nursing facility, to a Delaware business trust — the first time the U.S. Department of Housing and Urban Development (HUD) has granted approval for the use of a Trust as a Borrower

Acquisition: M&R closed a leveraged buyout of a 499-bed nursing home in Manhattan (Dewitt Rehab) for $105 million, including a $90 million bridge to HUD from KeyBank. The property is located on the Upper East Side of Manhattan and has always been looked upon as the most significant site in Manhattan available for eventual redevelopment into condominiums M&R however counseled the client to operate it as a Nursing Home and not base their offer on a hope of condominium development and it is now the premier skilled nursing facility in New York State.

Commercial Lending: Represented a major manufacturer of medical devices in connection with $60 million revolving credit and term loan facilities.

Defense of Physician in Regulatory Matter: Successfully represented a physician group in an investigation by the federal government regarding the purchase of non-FDA approved drugs from foreign sources. M&R helped develop an interpretation of the applicable licensing statutes to prove that the client was misled into purchasing the drugs from an unlicensed source, which appeared to be properly licensed by more than one state, to sell the medications at issue.

DIP and Exit Facilities: Represented a provider of national healthcare services, as borrower, in a $250 million debtor-in-possession financing and a $515 million exit financing.

Government Investigation: Successfully represented an emergency physician group being investigated by the Office of Inspector General for coding and billing irregularities, and other health care fraud as a result of a sealed qui tam suit filed under the False Claims Act. M&R negotiated with the Assistant U.S. Attorney to decrease the scope of the government subpoena, and retained experts to review the group’s billing and coding to corroborate the absence of fraud and abuse. We successfully defended the group, which resulted in the government choosing not to intervene in the qui tam suit, and the action being dismissed.

Independent Physician Association Reimbursement Dispute: Represented a large group of emergency physicians in litigation against an IPA to recover payment for services at physicians’ usual and customary rates. The Independent Physician Association (IPA) wrongly withheld several hundreds of thousands of dollars refusing to pay usual and customary rates for Current Procedural Terminology (CPT) codes as billed. M&R obtained a favorable settlement on the clients’ behalf, including payment of past amounts due, and structured agreed-upon contract rates going forward.

Mental Health Facility Acquisition: Represented both buyers and sellers in the acquisitions of mental health facilities across the country.

Mergers and Acquisitions: Led a team of lawyers in the roll up of medical service providers, including the purchase of an ambulatory service provider and an in-home care provider. Negotiated the terms of sale, the purchase agreement, organized a new holding company and assisted in the negotiation for new debt and equity for the combined firm.

Nursing Home & Rehabilitation Facility - Refinance: Counseled client in the $13 million refinance of Peninsula Nursing Home and Rehabilitation Facility in New York. This was a rather complicated matter in that a previous purchaser acquired a hospital and nursing home, broken up as two parcels, and kept the hospital while putting the nursing home, which was physically attached to the hospital, up for sale. Our client purchased the nursing home. During this process, we encountered several legal obstacles, not the least of which was an environmental issue related to construction debris and chemical traces at the nursing home site. M&R attorneys worked diligently with an environmental study company to revisit their report in light of new facts, thereby clearing any environmental roadblock and enabling the client to refinance.

Residential Long-Term Care - HUD Refinance: M&R helped our client close on the refinance of Middletown Park Manor Rehabilitation and Health Care Center, consisting of a $23,240,000 mortgage insured by the Department of Housing and Urban Development (HUD). This matter commenced in March 2010 with the purchase of the 240-bed facility by one of our long-time clients. After two refinances and a workout of the original purchase money financing, the project finally stabilized and was able to obtain a 35 year self-amortizing HUD mortgage with no personal guarantees and, most notably, a return of a substantial portion of the client’s original equity.

Substance Abuse Treatment Facility Administrative Hearing: Represented detoxification facility in administrative action brought by the California Department of Health Care Services seeking revocation of client’s license.

Substance Abuse Treatment Facility Compliance: Developed policies and procedures for substance abuse providers relating to marketing, referrals and payor relationships to ensure compliance with Federal and state regulations.

Substance Abuse Treatment Facility Compliance: Represented addiction treatment facility operator in $100 million federal lawsuit against several treatment centers, testing labs, and individuals, alleging financial kickbacks, fraud and other violations. M&R filed a motion to dismiss the federal claims, which was ultimately granted by the Florida court, and with no remaining jurisdiction over the plaintiff's state law claims, the case was dismissed. This represented a significant victory for our client and for the addiction treatment community.

Substance Abuse Treatment Facility Litigation: Represented substance abuse treatment provider in national litigation involving alleged kickbacks from toxicology laboratory.


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