The healthcare practice of the Wise Carter Child & Caraway law firm began almost 30 years ago and has evolved into a large section for the Jackson-based group. They represent all sectors of healthcare, including hospitals, clinics and services. Some 15 to 20 employees, including several partners, work on healthcare at different times, and 10 to 15 work exclusively in that area.
It all began when the firm helped draft bylaws for the Mississippi Hospital Association in the 1970s and has grown as federal and state regulations have increased for healthcare providers. Three key people, Margaret Williams, George H. Ritter and Eugene R. Naylor, point out that there are sub specialties within the healthcare law practice area.
“No one can do it all,” Williams said. “We must know federal laws, and Medicare and Medicaid laws are just as detailed as tax laws and have many changes. We get a lot of work from lawyers who don’t have time to stay up to date on regulations.”
Williams primarily works with Stark law and fraud and abuse issues. The Stark law specifies that no healthcare provider can have a financial interest in an entity to which he or she refers patients. “That is unless it falls within some exceptions,” she said, “and there are about 30 pages of exceptions to the law.”
Ritter said the firm’s healthcare practice has grown as regulations have grown. “The federal and state governments make it more difficult for our clients to practice,” he said. “We’ve had steady, sustained growth of competent lawyers who put clients first and provide them with good representation.”
When Carter Wise began with the hospital association, much of the healthcare practice was built on helping hospitals, Naylor said. “They come to us with questions although a lot of them have taken a more active role in their risk management and some self insure,” he said. “We consult with them to minimize risks.”
That’s an important trend, Williams added. “More hospitals now have in-house risk staff and some have in-house lawyers. Twenty-five years ago, hospitals had no compliance officers.”
The list of services the firm provides to clients includes the following:
• Transactions — Stark Law, fraud issues, acquisitions, leases.
• Malpractice litigation — defense of hospitals and physicians.
• Issues with the Emergency Medical Treatment and Active Labor Act (EMTAL Act) which places an obligation on hospitals with emergency rooms.
• Medical staff issues — also can include disciplinary actions and drafting bylaws for hospital staffs.
• Taxation and benefit plans.
• Compliance programs.
• Certificate of need.
• Specialty healthcare litigation.
• Re-imbursement issues.
• Work with state licensing boards for individual practitioners.
• Labor and employment issues such as those that come up for all employers.
“Our diversity allows us to provide what clients need,” Ritter said. “Collectively we’ve developed a deep understanding of healthcare laws and issues. Client needs are referred to the attorney with the expertise for that particular matter.”
Members of the firm’s healthcare section help each other stay abreast of issues and share resources within the firm. They also participate in national associations to learn regulatory changes and stay up to date.
“The general public doesn’t understand how complicated the healthcare system is now,” Naylor said. “A lot is driven by regulations and burdens put on providers. They’re working hard to provide quality care.”
Williams said she can’t count how many times clients tell her they just want to practice medicine and not deal with regulations. That isn’t likely to happen.
“The trend is for more and more regulations just like the general public sees in the newspapers,” Ritter said. “Every time the government decides to tweak the healthcare system, it creates more work for providers.”
Transactions that were relatively simple and would not have necessitated a call to a lawyer 25 years ago now do require legal advice because the risks are too great otherwise.
Mississippi’s recent tort reform laws have eliminated the threat of huge verdicts that would put a healthcare provider out of business in the past, Ritter said. “However, the caps are set to allow anyone with a legitimate suit to be compensated,” he added.
Naylor said that litigation spans all issues and fluctuates. “It’s at a more manageable level now, but it’s still the single thing healthcare providers need,” he said.
The HIPPA law mandating strict privacy of patient records is also creating more work for the firm’s healthcare clients. “We helped draft papers during the phase-in stage of HIPPA,” Williams said, “and we had requests to write papers and speak to groups. We still receive inquiries from clients.”
The attorneys agree their practice has grown as government regulations have grown, making it difficult for their clients to concentrate on practicing healthcare. Any continued growth the law firm has will be fueled by clients’ needs and putting them first with good legal representation
Contact MBJ contributing writer Lynn Lofton at firstname.lastname@example.org..