Firm profile submitted by Health Law Consultancy
Managing Attorney: Kathryn Roe
Number of partners: 2
Health Law Consultancy is a Chicago boutique law firm delivering legal services for the business of healthcare. The firm’s attorneys assist healthcare industry participants to identify and capitalise on opportunities and manage challenges in health law. The firm’s legal services focus on the operations, administration and financing of healthcare, with particular proficiency in health reform; strategic and operational transactions and contracting; antitrust and fraud and abuse compliance; health data privacy and security; and government health programs. The firm supports early stage and emerging ventures seeking to succeed, and incumbent organizations seeking to evolve, in the changing healthcare sector. Health Law Consultancy is the health law practice member of the Chicago chapter of INBLF - International Network of Boutique and Independent Law Firms.
Leading edge mastery of health reform under and beyond the Affordable Care Act.
■ Educate state executive, legislative and agency leaders and health industry participants on establishing and operating state-based health insurance exchanges under the Affordable Care Act
■ Develop and analyze private coverage options for state Medicaid expansion under the Affordable Care Act for health industry trade association and its members
■ Counsel, advise and interpret myriad issues under the Affordable Care Act and its implementing regulations affecting health insurance markets and products and Medicare and Medicaid programs
Transactions & Contracting:
Skilled in structuring, negotiating and documenting health industry joint ventures, affiliations, alliances and other strategic transactions, business process and administrative outsourcing arrangements, and health IT licensing and services contracts.
■ Structure and document physician-hospital organization for hospital system and affiliated physicians for payer contracting
■ Structure, negotiate and document care coordination and value-based payment arrangements between health plans and participating providers
■ Structure, negotiate and document commercial and government health program pharmacy benefits management agreements
■ Negotiate and document vendor arrangements for performance measurement and improvement, quality reporting and population health services
Antitrust/Fraud & Abuse Compliance:
Long experience and keen knowledge of antitrust and fraud and abuse issues affecting healthcare business operations, arrangements and relationships.
■ Counsel, support litigation and coordinate with federal and state antitrust agencies investigating and challenging health industry mergers and acquisitions
■ Counsel and advise on antitrust and fraud and abuse implications of health care arrangements and activities, including mergers, acquisitions and joint ventures, collaborations and joint negotiations, and accountable care organizations
Health Data Privacy & Security:
Unmatched knowledge and comprehension of HIPAA and other health data privacy and security statutes and regulations.
■ Advise and support early stage and emerging health industry technology companies on collection, use, disclosure and protection of health data, and business associate arrangements and contracts
■ Counsel health industry trade association on privacy management for electronic health information exchange to support member organizations’ accountable care and medical home initiatives
■ Guide state university on HIPAA, FERPA and Substance Use Disorder Patient Records Confidentiality Rule implications and options for student health insurance and student health services
■ Investigate, assess and advise on whether unauthorized transfer of health data by technology contractor caused reportable data security breach
Government Health Programs:
Fully conversant with the requirements and obligations for Medicare, Medicaid and other government health program participation.
■ Transfer and novate health insurer’s Medicare Advantage, Medicare Part D and Medicare-Medicaid dual eligible contracts to subsidiary focused on government business
■ Advise and assist with structuring, documenting and implementing government-mandated programs for Medicare and Medicaid compliance, fraud, waste and abuse control, and vendor oversight
■ Counsel on structure and options for Medicaid managed care arrangements with State Medicaid agencies
■ Investigate and advise on potential claims for Medicaid underpayments from Medicaid managed care organizations