Health Care Practice

PRACTICE AREA CONTACTS: Paul J. Maloney and Edward J. Krill

Carr Maloney recognizes the diverse legal needs of its health care clients, and our wide-ranging practice addresses the needs of hospitals, physician groups, nursing homes and other individual and institutional health care providers. This representation includes litigating the full range of issues that arise in the health care setting, including professional liability, commercial, employment and reimbursement cases. We also advise clients on issues such as business counseling and transactions, compliance with government regulations, risk management, patient care, bioethics and medical staff issues. In addition, we conduct management seminars and educate employees on hot topic health care issues of the day.

Health Care Litigation

Our firm has substantial experience litigating health care cases in the mid-Atlantic region. Our attorneys represent nursing homes, assisted living facilities, hospitals, physicians, dentists, podiatrists, psychiatrists, nurses and other health care providers.

Nursing Home and Assisted Living Facilities

Claims alleging nursing home and assisted living liability are rapidly becoming among the most litigated matters in the health care field, and we expect that this trend will continue as the population of seniors in the United States rises. Carr Maloney has extensive experience defending nursing homes and assisted living facilities in cases involving claims of wrongful death, failure to give proper care and attention to patients (including the elderly), patient abuse and neglect, simple negligence, failure to diagnose, and negligent hiring, supervision and retention, among others.

Licensing Disputes

Carr Maloney represents institutions and professionals before licensing boards in all jurisdictions within the mid-Atlantic region. We counsel clients upon receipt of a complaint, through the investigation phase, and through the administrative hearing, if necessary. Throughout each of these phases, we work diligently with our clients to reach an early, favorable resolution.

Reimbursement Litigation

Unfortunately, health care institutions frequently have to litigate reimbursement claims. These claims include recovery of reimbursement that has been denied based upon allegations of incorrect CPT coding, lack of compliance with conditions for payment, experimental treatment exclusions and reasonable cost limitations. We have litigated such claims on behalf of our clients against health insurers, managed care plans, government entities and other third-party payors.

We also present claims for reimbursement to health insurers, managed care plans and other third-party payors. These claims include reimbursement of monies denied because of alleged use of incorrect CPT coding, lack of compliance with conditions for payment, experimental treatment exclusions and reasonable cost limitations.

Professional Malpractice

The most obvious type of litigation that arises from the health care field is professional malpractice. Our professional malpractice team regularly handles such matters.

Employment, Commercial, and Business Litigation

Like other large businesses, medical facilities and institutions face the gamut of employment liability, commercial disputes and other business-related issues. Our firm’s extensive experience in each of these areas can be found on our employment litigation practice and commercial and business litigation practice pages.

At Carr Maloney, we understand health care institutions’ unique employment-related needs and issues. The evaluation of an employee’s clinical performance can be a difficult task, especially when it may lead to adverse action. Our firm successfully guides clients through these complex employment matters, and we also defend clients against claims asserted by third parties (regarding negligent hiring, supervision and retention, etc.) and employees (discrimination, harassment and breach of contract, etc.).

Health care clients face an array of labor-related issues. Understanding their concerns, our firm represents a variety of clients in collective bargaining, dispute resolution and personnel administration in a unionized setting. When parties to a labor dispute cannot resolve their differences, we represent our clients in arbitration, in state and federal courts, and in unfair labor proceedings before the National Labor Relations Board.

Our firm is attuned to the business and commercial challenges facing the health care industry. With our broad-based business and commercial practice, we litigate matters involving real estate property rights, trademark infringement, unfair competition claims, product defect and warranty issues, construction contract disputes and vendor/contractor performance problems.

Health Care Business

Carr Maloney advises and represents health care clients in a variety of business and transactional matters. Examples of such matters are provider contracts and internal labor and employment issues in the health care setting. We regularly represent parties in the formation of provider organizations, sales of professional practices and related regulation compliance.

We advise physician, hospital and nursing home clients in complicated Medicare requirements and the legal issues that arise with participation in managed care plans, HMOs, PPOs and IPAs. Our health care attorneys also counsel clients on employee benefits, including the ERISA aspects of health care coverage, as those issues arise.

Risk Management

Our firm drafts, reviews and revises institutional clients’ internal and external policies and procedures. Such policies and procedures include those on incident reporting and the operation of medical staff peer review committees. Our attorneys also assist clients in the selection and supervision of outside defense counsel, litigation support services and claims investigation. Our clients rely on us to form litigation strategy and, wherever possible, to reach a prompt and cost-effective resolution.

We also counsel clients on institutional liability issues for medical staff members’ acts and omissions and the statutory obligations governing treatment of patients. We consult with clients regarding the sufficiency of quality assurance programs and advise them as to risks faced when outsourcing services, products and departmental supervision. Once risks are identified, we work with our clients to minimize their potential exposure and avoid litigation.

Patient Care Issues and Bioethics

Every health care provider has policies, procedures and protocols that prescribe proper patient care services. Health care providers have strict responsibilities regarding informed consent, substitute consent, and withdrawal or termination of treatment in instances of terminal illness or futile medical treatment. We advise clients regarding the legal implications of those responsibilities and represent clients in court proceedings when intervention is necessary to permit them to render appropriate care or treatment.

We also guide clients through the implementation and operation of clinical research programs. As part of those services, we advise clients regarding liability issues, proper progress reporting procedures and participation consent forms for human medical research. In the event of unexpected results leading to potential liability, our firm’s health care attorneys work with clients to formulate a strategy to minimize their exposure. If conflict cannot be avoided or quickly resolved, our health care litigation practice enables us to zealously defend our clients in litigation.

Regulatory Matters

The Firm advises clients on a broad range of issues including compliance with: antitrust laws, regulatory standards of the Federal Trade Commission, state licensing laws for physicians and hospitals, regulatory requirements regarding drugs and pharmaceuticals, environmental regulations dealing with the handling, storage and disposal of hazardous materials. We regularly represent institutional and individual clients in matters involving HIPAA, patient privacy compliance and federal restrictions regarding referral of patients.

Medical Staff, Credentialing, and Peer Review

We counsel clients regarding medical staff issues, such as credentialing and peer review, and, as part of this practice, we are regularly consulted by institutional clients to interpret and apply by-laws, policies and procedures. Our attorneys interpret and apply these documents to ensure compliance with standards of fairness and due process when dealing with medical staff issues. They also serve as administrative hearing officers in medical staff proceedings.

Management Seminars and Employee Education

Carr Maloney ’s health care team frequently presents risk management seminars and lectures to health care providers to minimize the risk of needless litigation. These seminars and lectures have addressed HIPAA, fair employment practices, physician licensure, negotiation of physician contracts, bioethics and other issues.

For information regarding publications and seminars by Carr Maloney, see Articles and News & Resources.