Cozen O’Connor provides sophisticated counsel to a wide variety of investors and operators within the health care industry. Our market advantage is our deep understanding of the legal regulatory framework and reimbursement in the space. We provide practical and cost-effective solutions. We help them manage risk and seize opportunities in this era of regulatory uncertainty, government scrutiny, innovation, challenging economics, and shifting demographics.
The firm focuses on transactional health care, reimbursements, regulatory matters, and health care litigation. We represent private equity and venture capital investors, health systems, hospitals, physician groups, long-term care and nursing home providers, life sciences and health technology companies, suppliers, drug and device companies, and health care entrepreneurs.
Our multi-disciplinary health care team includes attorneys with decades of relevant health care regulatory, litigation, and transactional experience.
Cozen O’Connor stands out from other large law firms for being able to provide comprehensive health law services nationwide, while maintaining an entrepreneurial business model that can scale offerings and rates to fit the specific needs of each client.
Our Health Law Group represents clients in the areas of:
Health Care Transactions
Cozen O’Connor’s full-service corporate practice handles complex business transactions for health clients, including mergers and acquisitions, divestitures, joint ventures and co-management agreements, venture capital and private equity investments, public offerings, and recapitalizations. We also assist with antitrust due diligence and reporting, as well as tax analysis and structuring.
Modern health care institutions require legal counsel who are well-versed in both corporate law and health law in order to complete major transactions. Whether arranging venture capital funding for a health technology startup or executing a hospital merger, Cozen O’Connor brings sophisticated understanding of business, finance, health industry operations, and health regulations to every deal.
We serve as transactional counsel for hospitals, health systems, physician groups, ACOs, clinically integrated networks, medical device manufacturers, private equity sponsors and portfolio companies, academic medical centers, and research organizations.
Our health care team provides counsel on transactions unique to the health care industry. We form ACOs, clinically integrated networks and physician practice groups, and negotiate contracts between providers and a multitude of different vendors. Cozen O’Connor represents management service organizations (MSOs), contract research organizations (CROs), tissue banks, and other nonprofit data centers. Clients rely on Cozen O’Connor’s detailed understanding of the health care business, health IP, payor policies, and federal research guidelines.
Payer Contracts & Value-Based Programs
Given the current regulatory climate, the need for clear and enforceable payer contracts has never been greater. The Health Law Practice at Cozen O’Connor counsels major health care clients in the areas of payer contracts, clinical integration, and value-based payment programs.
Cozen O’Connor represents health systems, hospitals, and large physician groups. Our attorneys are well versed in the intricacies of payer contracts and their practical implications.
Our Health Law Practice offers start-to-finish contract counsel. We negotiate payer contracts of all types and provide advice on cutting-edge contracting issues, such as utilization management, “tiering and steering,” and the impact of corporate structure on government payment eligibility. We provide sophisticated front-end payer contract counsel, and defend and enforce payer contracts in high-stakes payment disputes.
Cozen O’Connor is a recognized leader in value-based contracting and related risk-based payment programs. We also structure accountable care organizations and clinically integrated networks.
Payment Disputes
Cozen O’Connor is nationally known as a “go-to firm” for reimbursement disputes. Clients draw on our deep knowledge of laws governing the Medicare and Medicaid programs, as well as the financial and operational considerations specific to public and private-payor disputes.
The firm represents health systems, hospitals, and drug and device companies in litigation against private insurers, the federal government and state programs. The scope of our experience is vast and includes work on some of the most technically and legally complex disputes of the last decade.
We advise on issues involving: Medicare certification, premium subsidies, diagnosis-related groups (DRGs), site-of-service, out-of-network reimbursement, network termination, suspension of payments, continuity-of-care, recoupments, coding downgrades, coverage, ERISA, sequestration, and intergovernmental transfers. We have had cases before the Provider Reimbursement Review Board (PRRB) and the Departmental Appeals Board (DAB) of the Department of Health and Human Services and regularly appear in state and federal courts on behalf of our clients.
Cozen O’Connor’s practice is unusual in that we are capable of managing large multi-state or multi-plaintiff reimbursement litigation, but are also flexible enough to adjust our service model to meet specific client needs, including through use of alternative or contingency fee agreements.
Health Care Government Investigations
Cozen O’Connor defends health care clients in high-stakes federal and state agency investigations and litigation, including actions involving False Claims Act, qui tam, Anti-Kickback, Stark Law, and Sunshine Act claims. We are known for our ability to achieve early and decisive resolutions.
HIPAA & Health Data
No entity can operate in the health care field without paying constant and careful attention to health data privacy and security. Cozen O’Connor’s Health Law Practice helps major corporate clients meet the challenges of achieving regulatory compliance and keeping health data secure.
Cozen O’Connor represents HIPAA-defined “covered entities” (health systems, hospitals, physician groups, and other providers) and “business associates.” Cozen O’Connor also advises clients handling health care data outside the HIPAA regulatory structure, such as wellness programs, wearable devices, and websites. Our attorneys closely track health privacy and security laws, including HIPAA and HITECH, FTC, FDA, Gramm-Leach-Bliley, the GDPR, U.S. Privacy Shield, alcohol and drug abuse records, federal communications and trade statutes, and myriad state-based privacy and data breach laws.
Among the most important services Cozen O’Connor provides is comprehensive loss prevention. Our attorneys conduct deep-dive audits under the umbrella of attorney-client privilege; develop policies and procedures that integrate sophisticated physical, technical, and administrative safeguards; conduct client training on data privacy and security compliance; and draft and review contracts with business associates, subcontractors, and institutional partners.
In response to an alleged privacy violation or data breach, the Health Law team can perform immediate forensic and recovery operations, satisfy notification obligations, liaison with government officials, and design public messages to protect clients from liability. We lead complex internal investigations for high-profile health clients and represent them in federal and state government regulatory investigations, enforcement actions, state attorneys general litigation, class actions, and individual plaintiff lawsuits.
The firm’s work in health data privacy and security is significantly bolstered by our strong Washington, D.C.,-based government affairs and state attorneys general groups. Cozen O’Connor Public Strategies is at the forefront of tracking legislative developments on health data, and the firm’s 50-state AGs practice is well positioned to assist as regulatory responsibility devolves to the state level.
Digital Health
New technologies are transforming health care in America. From the growth in telehealth and telemedicine to the revolution in electronic data collection and analysis, digital health is affecting nearly every aspect of health care delivery.
Cozen O’Connor is a leader in digital health law. We represent innovative telehealth and telemedicine companies, technology companies, health care analytics firms, provider groups, and medical device manufacturers. Our attorneys bring decades of diverse experience in health care, technology, and emerging business development and provide comprehensive regulatory and corporate counsel.
We advise innovative digital health clients on compliance with analogue-era regulatory requirements, including all state and federal privacy and security rules; health fraud and abuse laws; and FCC, FDA, FTC, and state consumer protection requirements.
Our attorneys also provide integrated corporate counsel, assisting technology firms and health care companies on corporate structure, private equity, IP, commercialization, licensing, marketing, and contracts. We partner with emerging companies through every stage of their business life cycle. Our attorneys advise digital and tech-focused companies on medical liability risk management and coverage and reimbursement strategies with both government and private payors.
Cozen O’Connor not only advocates for individual clients, but also for the digital health industry. Through our Washington, D.C.,-based Public Strategies firm and State Attorneys General practice, we provide top-ranked government relations support. We track relevant legislative activity, advocate before state and federal governments, and build effective trade associations and policy-based coalitions.
Government Affairs
Cozen O’Connor Public Strategies, the firm’s bipartisan Washington, D.C.,-based government relations firm, provides outreach to public officials on matters of health law and policy. We advocate for clients before the Centers for Medicaid & Medicare Services, Department of Justice, Food & Drug Administration, state departments of health & welfare, and state and federal legislatures.
Medical Marijuana
The increased use of cannabis for medical purposes presents health care institutions, providers, and suppliers with a complex set of legal considerations. Cozen O’Connor has an interdisciplinary team of attorneys ready to advise on all applicable state and federal laws.
State Attorneys General
With one of the largest state attorneys general practices in the country, Cozen O’Connor represents clients in state AG investigations and litigation (including multi-state and federal co-enforcement actions). The State AG team has experience counselling health care clients faced with state-based consumer protection, antitrust, false claims, drug pricing, and data privacy claims.