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Health Care

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Certificate of Need/Licensure Issues

We are extensively involved in addressing health care facility certificate of need issues for our clients. Our attorneys have been instrumental in assisting clients with securing approval for certificate of need applications and structuring transactions to assure compliance with certificate of need requirements. We are well-versed in state health care facility licensure requirements and Medicare Conditions of Participation for various providers. We use this knowledge to assist clients in obtaining appropriate health care facility licenses and certification from state departments of health, Medicare and Medicaid and coordinating the transfer and re-application procedures for licensure and Medicare/Medicaid certification in the context of health care transactions.

We assist our clients in responding to licensure surveys and related government enforcement actions, including preparing plans of correction and appealing such enforcement actions through informal dispute resolution.
Partners
Allred, Allen D.
Buchholz, Edward J.
Fink, Jeffrey R.
Fogle, James L.
Friedman, Lawrence C.
Goldfarb, Evan Raskas
Goldstein, A. Jay
Goturi, Milada R.
Gunn, James F.
Hennessy, Joyce Harris
Kamensky, Robert N.
Landwehr, Matthew J.
Lang, Richard J.
Lause, Michael F.
Lawton, Richard L.
Lebow, Joan M.
Miller, Jan Paul
Mitchell, Steven B.
Morris, Michael J.
Schenk, Claire M.
Counsel
Daniel, Don L.
Ritzler, Suzanne E.
Associates
Gawne, Kelly L.
Jobe, Nicole K.
  • AmeriNet, Inc.
  • Anderson Hospital
  • Ascension Health
  • Bethesda Health Group
  • BJC Health System
  • Community Living, Inc.
  • Cooperative Home Care
  • CoreLink, LLC
  • Essence Group Holdings Corporation
  • The Gatesworth
  • Hillsboro Area Health System
  • McKnight Place Assisted Living
  • McKnight Place Extended Care
  • Mercy Fort Smith
  • Mercy Health
  • Mercy Oklahoma City 
  • Mercy Springfield
  • Mercy St. Louis
  • Midwest Neurosurgeons, LLC
  • Missouri Primary Care Association 
  • Parc Provence
  • Pharmerica Corporation
  • Prairie Spine & Pain Institute
  • Presbyterian Healthcare Services
  • QualSight, Inc.
  • Ranken Jordan, A Pediatric Specialty Hospital
  • Saint Anthony’s Health System, Alton, IL
  • Saint Peters Bone and Joint Surgery, Inc.
  • Sparta Community Hospital
  • St. Charles Orthopaedic Surgery Associates
  • United Healthcare Group
  • Thompson Coburn obtained a major victory for United Healthcare, who was sued by Signature Health Services, Inc., a 120-physician group, seeking to hold United Healthcare liable for millions of dollars in penalties under the federal racketeering statute (RICO) and the Missouri Prompt Payment Act. Signature also asked the court to revamp United Healthcare’s claim processing system. In May 2006, the district court ruled in favor of United Healthcare and rejected Signature’s claims. In March 2009, the Eighth Circuit affirmed the district court’s judgment. In a unanimous decision, the Eighth Circuit ruled that Signature did not have a viable RICO claim. 
  • We represented a health insurer in a class action lawsuit in Missouri alleging that the health insurer imposed copayments for medical services and outpatient prescription drugs that allegedly exceeded copayment limits in the health insurer’s ERISA-governed health plans and the Missouri Department of Insurance Copayment Regulation. 
  • We represented several hospitals in class action lawsuits in Missouri, Illinois and Arkansas brought by uninsured patients who alleged that the hospitals overcharged them for medical services because the hospitals did not afford to the uninsured patients the same discounts from the hospitals’ standard charges that the hospitals afforded to insurance companies pursuant to provider agreements or to the Medicare and Medicaid programs pursuant to statutes. Several of these lawsuits have been dismissed for failure to state a viable claim against the hospitals. In one lawsuit, class certification was denied. 
  • We represented a hospital in a class action lawsuit in Illinois challenging the hospital’s practice of asserting health care provider liens for the full amount of billed charges in automobile accidents where the patients had insurance coverage with insurers that had a provider agreement with the hospital under which the hospital agreed to accept a discounted payment from the insurers as payment in full. 
  • Our attorneys served as letter of credit bank counsel in connection with more than $400 million in bond and other financings for PeaceHealth, an integrated multistate hospital and health care system in the Pacific Northwest. The bonds were structured as variable rate securities issued by two state authorities and were enhanced by bank letters of credit provided by a syndicate of multiple banks led by two issuing banks. The firm documented both the bond letter of credit materials, as well as the bank syndicate materials. Our attorneys also represented the bank group agent in connection with a bridge line of credit that allowed the hospital system to access the credit markets in advance of the bond financing in order to avoid rising interest rates on its existing bond indebtedness. 
  • We assist clients with respect to the administration of retiree medical plans. We also counsel and defend clients with respect to the modification and termination of such plans. We successfully initiated a defendant class action related to our client, materially reducing its retiree medical benefits. 
  • We have represented numerous clients in negotiating, documenting and implementing merger, asset acquisition, membership interest/stock acquisition, joint venture, religious sponsorship and affiliation transactions for nonprofit and for-profit clients.