In The News

March 2013 Physicians' Legal Update

Bone McAllester Norton's Anne Sumpter Arney discusses a whistleblower suit against a hospital being rejected from district court as well as a new HIPPA rule that requires changes of notice to privacy practices

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Special Fraud Alert on Physician-Owned Distributorships

On March 24, 2013, the Office of the Inspector General (“OIG”) issued a Special Fraud Alert addressing its concern about the proliferation of physician-owned distributorships (PODS). PODs are physician-owned entities that derive revenue from selling, or arranging for the sale of, implantable medical devices ordered by their physician-owners for use in procedures the physician-owners perform on their own patients at hospitals or ambulatory surgical centers (ASCs). During the last several years, there has been a lot of discussion in the healthcare community about whether or not PODs violate the Anti-Kickback Statue, but until now, there has been little guidance from either CMS or the OIG.

In the Special Fraud Alert, the OIG reiterates its longstanding position that “the opportunity for a referring physician to earn a profit, including through an investment in an entity for which he or she generates business, could constitute illegal remuneration under the anti-kickback statute.” In addition, the OIG concludes that PODs are “inherently suspect under the anti-kickback statute.” The Special Fraud Alert provides a list of characteristics making any POD suspect which leaves open the possibility that a POD without any of the listed characteristics would not violate Anti-Kickback Statute.

The listed characteristics are all familiar red flags which have been cited many times by the OIG as indicative of a potentially abusive physician investment or arrangement. Although the OIG does not go so far as to make PODs a per se violation of the Anti-Kickback statute, the language of the Special Fraud Alert is strong. The OIG restates its longstanding guidance “that the opportunity for a referring physician to earn a profit, including through an investment in an entity for which he or she generates business, could constitute illegal remuneration under the Anti-Kickback Statute. The Anti-Kickback Statute is violated if even one purpose of the remuneration is to induce such referrals.”

Bone McAllester Norton PLLC is a full-service law firm with 33 attorneys and offices in Nashville and Sumner County, Tennessee. Our attorneys focus on 16 distinct practice areas, providing the wide range of legal services ordinarily required by established and growing businesses and entrepreneurs. Among our practices, we represent clients in business and capital formation, mergers and acquisitions, securities matters, commercial lending and creditors’ rights, commercial real estate and development, governmental regulatory matters, commercial litigation and dispute resolution, intellectual property strategy and enforcement, entertainment and environmental matters. Our client base reflects the firm’s deep understanding and coverage of today’s leading industry and business segments. For more information, visit www.bonelaw.com.

District Court Rejects Physician’s Whistleblower Suit Against Hospital

By Anne Sumpter Arney

It will be no surprise to the healthcare community that the relationship between doctors and hospitals is not always a friendly one. Nonetheless, physicians and hospitals seldom seek to resolve their disputes in the court room. This reluctance of physicians to resort to litigation to resolve their disputes is one of the things that makes a recent Tennessee case brought by a physician against University Medical Center (UMC) in Lebanon, Tennessee particularly interesting. In United States ex rel. Dennis v. Health Management Assocs., Inc., a physician on the hospital’s medical staff brought a qui tam, or whistle blower, suit against UMC, claiming that the hospital had violated the False Claims Act.   A qui tam lawsuit is not simply a claim by an individual who believes a contract has been breached or that rights have been damaged but is, rather, a claim that a federal law has been violated.  The individual who brings a qui tam lawsuit seeks to have the Office of Inspector General (or another governmental agency) join in the whistle blower’s suit and pursue damages on behalf of the government. If the government intervenes, the individual who brought the qui tam, in this case the physician, is entitled to receive a portion of the damages recovered by the enforcement action.  The recovery in qui tam actions can be substantial, and these cases are often brought by former employees of a healthcare provider but not usually physicians.

In this case, the physician claimed UMC had submitted claims to government insurers, such as Medicare, for services that had been provided in violation of the Anti-Kickback Statute and the Stark Law. The Anti-Kickback Statute and the Stark Law generally prohibit the payment for referrals of patients if the services are paid for by a government insurance program such as Medicare. Most hospitals carefully structure their recruitment arrangements to fall within an exception and not violate these laws. UMC appears to have had a typical recruiting agreement in which a hospital recruits a physician to an underserved area by underwriting a portion of their salary and expenses during the first years of practice. As is standard in most recruiting agreements, UMC required, among other things, that the recruited physician become a member of its medical staff.

In the lawsuit, the physician claimed, in part, that UMC’s recruiting agreements were a way for the hospital to pay the physician for referral because they required a recruited physician to maintain active staff membership at the hospital.  Further, as is also usual at most hospitals, in order to maintain his position on the medical staff, the physician was required to admit a certain number of patients to the hospital.

The physician’s claim against UMC was not successful, and on January 14, 2013, the District Court dismissed the suit with prejudice, finding that the claim did not give specific facts to find a False Claims Act violation. In rejecting the physician’s complaint, the District Court said “the only arena in which the relator (the physician) offers allegations of any specificity whatsoever, concern his own recruitment agreement with UMC.”   The Court recognized that the requirements of the recruitment arrangement at issue were not only standard practice but also specifically allowed under the law. The Center for Medicare and Medicaid Services has determined that in the context of recruitment a hospital may require, as a condition for receiving benefits, that the practitioner maintain staff privileges at the recruiting hospital. It is also a common practice for hospitals to classify their medical staff based in part on the number of admissions to the hospital per year.

The District Court’s conclusion is not as surprising. It is surprising that the qui tam lawsuit was brought by the physician and that the physician himself was party to the same recruiting agreement with UMC that was the basis for his lawsuit.  If the UMC recruitment agreement had been found to be a violation of the law, as a party to the recruitment agreement, the physician would himself have been guilty of violating the Anti-Kickback Statute and Stark Law.

 

Bone McAllester Norton PLLC is a full-service law firm with 33 attorneys and offices in Nashville and Sumner County, Tennessee. Our attorneys focus on 16 distinct practice areas, providing the wide range of legal services ordinarily required by established and growing businesses and entrepreneurs. Among our practices, we represent clients in business and capital formation, mergers and acquisitions, securities matters, commercial lending and creditors’ rights, commercial real estate and development, governmental regulatory matters, commercial litigation and dispute resolution, intellectual property strategy and enforcement, entertainment and environmental matters.   Our client base reflects the firm’s deep understanding and coverage of today’s leading industry and business segments. For more information, visit www.bonelaw.com.

New HIPPA Rule Requires Changes to Privacy Practices

By Anne Sumpter Arney

Since 2002, HIPAA has required physician’s offices as well as other healthcare providers to provide their patients with a Notice of Privacy Practices.  These notices are now familiar to everyone who is part of the healthcare industry, including patients.  Although they may differ slightly, they are substantially the same because the form and content is primarily dictated by the Privacy Rule under the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

On January 17 of this year, the U.S. Department of Health and Human Services issued the new final rules under HIPAA, which strengthen its privacy and security protections. This new final rule changed several aspects of the privacy and security rules in ways that will directly affect physicians, including modifying what must be included in your Notice of Privacy Practices. In addition to the information already required, a provider’s Notice of Privacy Practices must now include the following additional statements and information:

  • If a provider plans to use or disclose protected health information for fundraising, a statement that the provider may contact them to raise funds and that the individual has the right to opt out of receiving these fundraising communications.

  • If the provider maintains “psychotherapy notes,” a statement that the psychotherapy notes will only be used and disclosed with the individual’s authorization.

  • A statement that the patient has the right to restrict the disclosure of information to their insurer if they are paying out of pocket, in full for the care.

  • A statement that the sale of protected health information without the express written authorization of the individual is prohibited, as well as the other uses and disclosures for which the rule expressly requires the individual's authorization (i.e., marketing and disclosure of psychotherapy notes, as appropriate).

  • A statement that the covered entity has a duty to notify affected individuals of a breach of unsecured protected health information.


The other changes required by the new final rule will be addressed in future issues of the Physicians’ Legal Update.  A covered entity has until September 23, 2013 to update their Notice of Privacy Practices and to comply with the other requirements of the new rule.

 

Bone McAllester Norton PLLC is a full-service law firm with 33 attorneys and offices in Nashville and Sumner County, Tennessee. Our attorneys focus on 16 distinct practice areas, providing the wide range of legal services ordinarily required by established and growing businesses and entrepreneurs. Among our practices, we represent clients in business and capital formation, mergers and acquisitions, securities matters, commercial lending and creditors’ rights, commercial real estate and development, governmental regulatory matters, commercial litigation and dispute resolution, intellectual property strategy and enforcement, entertainment and environmental matters.   Our client base reflects the firm’s deep understanding and coverage of today’s leading industry and business segments. For more information, visit www.bonelaw.com.

 

Anne Sumpter Arney Re-Elected as Chairman of Metropolitan Nashville Beer Permit Board

Bone McAllester Norton congratulates Anne Sumpter Arney for being re-elected chairman for the Metropolitan Nashville Beer Permit Board. After a successful year in that same role, the group re-elected her. Congratulations, Anne! You are a great example of service and will serve the role well!

Anne Sumpter Arney Re-Elected as Chairman of Metropolitan Nashville Beer Permit Board

Bone McAllester Norton congratulates Anne Sumpter Arney for being re-elected chairman for the Metropolitan Nashville Beer Permit Board. After a successful year in that same role, the group re-elected her. Congratulations, Anne! You are a great example of service and will serve the role well!

Congratulations to Anne Sumpter Arney and Stacey A. Garrett for being named to the Nashville Medical News InCharge Healthcare list

Bone McAllester Norton congratulates Anne Sumpter Arney and Stacey A. Garrett for making Nashville Medical News InCharge Healthcare list for 2013. This recognition goes to those who help drive local innovation and shape the next iteration of the healthcare industry in Nashville. Congratulations, Anne and Stacey, for this well-deserved recognition.

Congratulations to Anne Sumpter Arney and Stacey A. Garrett for being named to the Nashville Medical News InCharge Healthcare list

Bone McAllester Norton congratulates Anne Sumpter Arney and Stacey A. Garrett for making Nashville Medical News InCharge Healthcare list for 2013. This recognition goes to those who help drive local innovation and shape the next iteration of the healthcare industry in Nashville. Congratulations, Anne and Stacey, for this well-deserved recognition.

BMN Healthcare Practice Group Presents Panel Discussion about Life Stages of Estate and Tax Planning

The Nashville Academy of Medicine, Bone McAllester Norton and Regions Bank presented a panel discussion about The Life Stages of Estate and Tax Planning: What You Need to Know Before the End of 2012 on Tuesday, October 16, 2012 at 6:00pm at the University Club of Nashville.

 
 

Healthcare Attorney Anne Sumpter Arney's Physician's Legal Update

Healthcare Attorney Anne Arney shares her insight on the industry.

Click here to read her newsletter.

 

Anne Sumpter Arney's Physicians' Legal Update

The High Cost of Failing to Comply with HIPAA
For the first years after the adoption of the HIPAA Privacy and Security Rules, their enforcement appeared to be limited. At that time, it was difficult to predict the potential penalty for a violation. Click here to read entire newsletter.

Protecting Patient Privacy in Discarded Medical Records

Over the past few years, physician practices have implemented many policies and procedures to protect their patients' privacy in an effort to comply with the Privacy and Security Rule under HIPAA.


 They have adopted compliance plans and procedures to protect their patients' privacy in the transmission and storage and use of their protected health information (“PHI”).  The need to protect the privacy and security of this information does not end when the medical record is no longer needed by the practice.  Failing to implement reasonable safeguards to protect PHI in connection with disposal of your medical records could result in impermissible disclosures of PHI with the same risks and penalties as the disclosure of information from active medical records. In addition to the policies that your office has in place to secure its active medical records, every medical office should have developed a HIPAA compliant policy to dispose of medical records that are no longer part of a patients active medical file. This is particularly important in the age of electronic records. Any procedures for the proper disposal of medical records should specifically address the disposition of electronic PHI and the hardware or electronic media, such as PCs, hard drives, and disks, on which it is stored.


A physician’s office may not simply abandon PHI or dispose of it in dumpsters or other containers that are accessible by the public or other unauthorized persons. However, the Privacy and Security Rules do not provide any particular disposal method for PHI that will guarantee compliance. Instead, a practice should determine what is reasonable for their office and consider a methods potential risks to patient privacy, keeping in mind the form, type, and amount of PHI to be disposed of. For instance, the disposal of certain types of PHI such as name, social security number, driver’s license number, debit or credit card number, diagnosis, treatment information, or other sensitive information may warrant more care due to the risk that inappropriate access to this information may result in identity theft, employment or other discrimination, or harm to an individual’s reputation.


The Office of Civil Rights provides some guidance for disposing of PHI.  Depending on the circumstances, proper disposal methods may include (but are not limited to):


• Shredding or otherwise destroying PHI in paper records so that the PHI is rendered essentially unreadable, indecipherable, and otherwise cannot be reconstructed prior to it being placed in a dumpster or other trash receptacle;


• Maintaining PHI for disposal in a secure area and using a disposal vendor as a business associate to pick up and shred or otherwise destroy the PHI;


• In justifiable cases, based on the size and the type of the covered entity, and the nature of the PHI, depositing PHI in locked dumpsters that are accessible only by authorized persons, such as appropriate refuse workers;


• For PHI on electronic media, clearing (using software or hardware products to overwrite media with non-sensitive data), purging (degaussing or exposing the media to a strong magnetic field in order to disrupt the recorded magnetic domains), or destroying the media (disintegration, pulverization, melting, incinerating, or shredding).


There are also outside vendors who can assist a medical practice to appropriately dispose of PHI on its behalf.


 

April 2011 Newsletter Features Human Rights Leaders, ATHENA, Top 40, Margaritaville, Real Estate, & Medical Records

Bone McAllester Norton attorneys continue to gain recognition in the Nashville community.  The firm also sponsored "Day on the Hill" Luncheon for the Tennessee Bankers Association Young Lawyers Division, and made sure to keep the theme fun.  To read the rest of our newsletter, click here.

Third Circuit Addresses Hospital Contract with Hospital-Based Physician Group

Appeared in the July 2009 Physicians Organizations Practice Group Newsletter reprinted courtesy of the American Health Lawyers Association.

On January 21, 2009, in the case of United States ex rel. Kosenske v. Carlisle HMA, Inc.(1), the Third Circuit reversed the decision of the district court(2) which had dismissed an action under the False Claims Act(3) which alleged that an arrangement between an anesthesiology group and a for-profit hospital violated the Stark and Anti-Kickback Acts(4) (collectively, the Acts). The Third Circuit agreed with the district court that the arrangement implicated the Acts but disagreed with the lower court’s conclusion that a written agreement entered into in 1992 continued to meet all of the requirements of the personal service exception under the Stark Act. The Third Circuit applied the Stark Act broadly to the relationship between the hospital and physician group, but strictly construed the criteria necessary to qualify for an exception. The Third Circuit’s opinion provides useful guidance for hospitals and hospital-based physicians by clarifying that a hospital-based physician group’s relationship with the hospital must be documented by a written agreement that clearly sets forth the terms of an arrangement that currently meets the requirements of an exception under the Stark Act.


Background


In December 1992, Blue Mountain Anesthesia Associates PC, a group of four anesthesiologists (Group), entered into an agreement (1992 Agreement) with Carlisle Hospital and Health Systems, Inc. (CHHS) to provide anesthesia services to the hospital facility (Hospital). The 1992 Agreement provided that: (1) the Group would provide anesthesia coverage on a twenty-four-hours-a-day, seven-days-a-week basis; (2) the Hospital would provide the space, equipment and supplies reasonably needed by the Group to provide the services without charge; and (3) the arrangement would be an exclusive one for both the Hospital and the Group. The 1992 Agreement did not mention the services being provided outside the Hospital and, at the time they entered into the 1992 Agreement, no pain management services were provided by the Group.


A little more than a year after the 1992 Agreement was signed, Ted Kosenske, a member of the Group, began providing pain management services in space that the Hospital used for other purposes.  In 1998, CHHS built a new, stand-alone facility containing an ambulatory surgery center and a pain management clinic (Pain Clinic). The Group provided pain management services at the Pain Clinic and CHHS did not charge the Group for the space, equipment or personnel. The Group’s physicians providing pain management services at the Pain Clinic did not provide anesthesiology services at the Hospital. For both the anesthesia and pain management services, the Group submitted claims to Medicare for the professional services and CHHS submitted claims for the facility and technical components. In June 2001, Carlisle HMA Inc. (HMA) purchased the assets of the Hospital from CHHS. The 1992 Agreement was not assigned by any written document. However, both the Group and HMA continued the arrangement with each other as if the 1992 Agreement was assigned.


Kosenske, a former member of the Group(5), brought a qui tam action under the False Claims Act against HMA and its parent company, Health Management Associates Inc., alleging that they submitted outpatient hospital claims to the Medicare program and other federal healthcare programs falsely certifying that such claims were in compliance with the Acts.


Analysis


The district court considered the issues raised in the claim in connection with the parties’ cross-motions for summary judgment and held that the arrangement between HMA and the Group implicated the Stark and the Anti-Kickback Acts. The district court noted that both of the Acts prohibit a health care provider from paying physicians any form of compensation to induce them to refer patients to the provider, and from holding a financial interest in a healthcare entity to which they refer patients. The district court also held that the relationship between HMA and the Group involved both referrals and compensation.


Under the arrangement, HMA provided the Group office space, supplies, equipment and personnel without charge, as well as other benefits. Under the 1992 Agreement, the Group was granted the exclusive right to provide anesthesiology and pain management services. The district court agreed with the claimant, Kosenske, that these benefits constituted remuneration under the Acts. Kosenske also argued that the right to receive payment from a third-party payor for services to patients referred to the Group by the Hospital was a benefit that constituted remuneration for the purposes of the Acts. The district court rejected this argument, stating: “The court need not decide whether payment from third party payors or the expectation of payment constitutes remuneration for the purposes of the Stark Act. However, the court would be remiss if it did not express its doubts as to the merits of this attenuated argument.(6)


However, the benefits to the Group under the 1992 Agreement resulted in a compensation arrangement and financial relationship between the Group and the Hospital. The district court determined that the Group ordered numerous pain management services, and that these orders constituted referrals. Therefore, because the Hospital submitted claims to Medicare for these services, the arrangement would violate the Stark Act unless it qualified for an exception. The district court noted that the Anti-Kickback Act requires the “knowing and willful” payment of remuneration to a provider for the referral of services covered by a federal health care program, but it concluded without any additional factual consideration that the Anti-Kickback Act was also violated.


Although the relationship between the Hospital and the Group fell within the ambit of the Stark and the Anti-Kickback Acts, the district court determined that the Hospital demonstrated it met the requirements of the exception for personal services under the Acts. On Appeal, the Third Circuit agreed with the district court that there was clearly a financial relationship between the Hospital and the Group, but rejected the district court’s holding that the relationship qualified for the personal services exception.


The Third Circuit held that HMA had failed to show that the requirements of the Stark personal service exception had been met. The Third Circuit found the arrangement between the Group and HMA failed to meet the criteria of the exception by failing to have a written agreement that covered all of the services to be provided by the Group and by not adequately demonstrating that the compensation under the agreement was at fair market value.


The personal services exception applies if:


(i) the arrangement is set out in writing, signed by the parties, and specifies the services covered by the arrangement,
(ii) the arrangement covers all of the services to be provided by the physician…to the entity,
(iii) the aggregate services contracted for do not exceed those that are reasonable and necessary for the legitimate business purposes of the arrangement,
(iv) the compensation to be paid over the term of the arrangement is set in advance, does not exceed fair market value, and… is not determined in a manner that takes into account the volume or value of any referrals or other business generated between the parties, and
(v) the services to be performed under the arrangement do not involve the counseling or promotion or a business arrangement or other activity that violates any state or federal law(7).


The district court held that the 1992 Agreement continued to satisfy the requirement that the “arrangement be set forth in writing,” even though there was no written assignment of the 1992 Agreement when the assets of the Hospital were sold to HMA. The district court pointed out that the 1992 Agreement contained a provision stating that it would be binding on the parties’ successors and assigns. The district court applied Pennsylvania law and held that, because the actions of the parties after the sale of assets demonstrated their intent that HMA succeed to the position of CHHS under the 1992 Agreement, no specific assignment of the 1992 Agreement was necessary to satisfy the requirements of the exception(8).  The district court also determined that the 1992 Agreement satisfied the second requirement of the exception that the written agreement cover all services to be provided by the physician. When the 1992 Agreement was entered into, the Group was providing only anesthesia services to the Hospital, and it was not until 1998 that the Hospital opened the Pain Clinic. However, the 1992 Agreement included language granting the Group the right to provide physician services in the event the Hospital obtained, opened, or operated another facility or location at which anesthesiology or pain management services were required or offered. The district court held that this language in the 1992 Agreement adequately described the full range of services provided by the Group to the Hospital and met the Stark exception’s second requirement.


The Third Circuit disagreed with the district court’s analysis and stated:


In this case, the only written contract in existence between the parties is one that did not, and obviously was not intended to apply to services at a non-existent facility. It was negotiated in 1992, in a context wholly different from the one that existed six years later after the opening of the Pain Clinic. . . and the opening of the Pain Clinic represented a very substantial change(9).


The 1992 Agreement did not mention the provision of space, equipment and personnel without charge, and the Third Circuit appeared to find that broad language contemplating that the parties might provide each other additional services at a future date was not enough to support an argument that these services continued to be covered by a written agreement.


The Third Circuit also disagreed with the district court’s holding that the compensation under the 1992 Agreement satisfied the “fair market value” requirement under the Stark exception. The district court held that there was a “mutuality of rights and responsibilities imposed by the 1992 agreement” and that this was evidence that the compensation to the parties was a fair market value exchange. The district court went on to conclude the following, “By definition, the terms of the contract reflect the fair market value of the benefits conferred on each party(10).”  Not surprisingly, the Third Circuit rejected this argument. The Third Circuit concluded that it is impossible for a contract entered into six years earlier to reflect current fair market rates and further dismissed the lower court’s interpretation of the definition. Instead, the Third Circuit corrected the district court and stated that “as a legal matter, a negotiated agreement between interested parties does not ‘by definition’ reflect fair market value.” The Third Circuit concluded that the arrangement between the Group and the Hospital was exactly the type of situation which the Stark Act recognizes as potentially abusive. The Hospital and the Group were in a position to generate business for each other; therefore, their negotiations were not arms’ length(11).


The Third Circuit and the district court agreed that the exclusive arrangement between a hospital and a hospital-based physician group implicated the Acts. Both Courts concluded that the reciprocal responsibilities are enough to create a financial relationship and referrals governed by the Acts. The Third Circuit specifically rejected HMA’s argument that there is no fair market value issue because the Hospital and the Group were being compensated for their services by a third-party payor. The Third Circuit also rejected HMA’s argument, based on 42 C.F.R. § 413.65(d)(2)(vi), that the arrangement did not include referrals, and that the Stark Act did not apply because the facility was provider-based and the patients treated by the Group were Hospital patients:


HMA reads this sub-section [42 C.F.R. § 413.65(d)(2)(vi)] as depriving physicians at the facility of any discretion in making referrals of their patients, i.e., as mandating referrals to the main provider. We believe HMA reads too much into this provision. While Pain Clinic patients clearly must have access to all services provided by the Hospital in order for it to be considered a part thereof, we are unpersuaded that BMAA physicians at the Clinic have been deprived of the right to refer their patients in accordance with their best medical judgment(12).


Conclusion


Even if the Third Circuit had upheld all of the district court’s holdings, the result in this case would have supported the position that arrangements between hospitals and hospital-based physicians fall within the ambit of the Acts and should be structured to qualify for an exception under the Stark Act and a safe harbor under the Anti- Kickback Act.


In addition, Kosenske makes it clear that the parties’ intent to extend an arrangement that might have originally fallen within an exception to the Acts will not necessarily continue to protect the parties from prosecution if there has been a significant change in circumstance. Compliance with the Acts requires that hospitals and physicians review and revise their contracts when an arrangement has developed into something more than the original services, or when enough time has passed that the compensation’s value may have changed. Finally, the Third Circuit decision once again reminds providers and their lawyers that a complete and well drafted paper trail is important to compliance under Stark and the Anti-Kickback Act.


_____________________________________________________________________________________
1. 554 F.3d 88, 98 (3d Cir. 2009), rev’g No. 1:05-CV-2184, 2007 WL 3490537 (M.D.Pa., Nov. 14, 2007).
2. 2007 WL 3490537
3. 31 U.S.C. §§ 3729-3733 (“False Claims Act”).
4. 42 U.S.C. § 1395nn (“Stark Act”); 42 U.S.C. § 1320a-7b (“Anti-Kickback Act”).
5. Kosenske left the Group in 2005 to establish an independent pain management practice.
6. 2007 WL 3490537 at *7, n.9.
7. 42 U.S.C. § 1395nn(e)(3)(A); see also 42 C.F.R. § 411.357(a)(1).
8. 2007 WL 3490537 at *8 & n.14 (citing Bogart v. Phase II Pasta Machines, Inc., 817 F.Supp 547, 548 (E.D.Pa. 1993) for the proposition that, under Pennsylvania law, acquiring corporations become successors if they expressly or impliedly agree to assume the liabilities of the seller or if they continue to operate the seller’s business).
9. 554 F.3d. at 96-97.
10. 2007 WL 3490537 AT *10.
11. 554 F.3d. at 97.
12. Id. at 98.


 

November 2010 Newsletter Features New Attorney, Anne Sumpter Arney

Bone McAllester Norton is thrilled to welcome Anne Sumpter Arney to the firm.  To read the rest of our newsletter click here.

Anne Arney Adds Healthcare Expertise to Bone McAllester Norton

Anne Sumpter Arney, an experienced attorney in health care law, has become a partner of Bone McAllester Norton, Chairman Charles W. Bone announced today.


“Anne is one of the leading Nashville attorneys in health care law, and we are pleased to have her expertise and guidance in this area,” Mr. Bone said.  “Nashville is recognized nationally and internationally as a health care industry mecca with a local impact of nearly $30 billion and over 200,000 jobs.  We’re privileged to have Anne’s leadership in this ever-growing field.”


Ms. Arney has been practicing law for nearly 30 years, serving clients in general business and the health care industry.  Ms. Arney represents clients in matters ranging from general corporate to complex transactions.  She has extensive experience with the health care industry, representing businesses and health care providers in corporate, operational, and regulatory matters.


“I look forward to practicing law with Bone McAllester and Norton,” Ms. Arney said.  “I have had the opportunity to work with many of the attorneys at the firm and I know the high quality of services they provide to their clients.”


Ms. Arney is a member of the Nashville, Tennessee and American Bar Associations, the American Health Lawyers Association, and is a Fellow of the Nashville and Tennessee Bar Foundations.  She serves on the Board of the Nashville Bar Association and is a member of the American Bar Association’s Section on Health Law and the Tennessee Board of Medical Examiner’s Committee on Physician’s Assistants.


She has been a guest speaker on the topics of health care and corporate law for industry and professional associations and has authored a number of articles for medical and legal publications.


A native of Livingston, Overton County, Tennessee, Ms. Arney is an alumna of Vanderbilt University where she graduated cum laude with a bachelor of arts in English.  She received her law degree from Washington & Lee University School of Law in Lexington, Virginia.


She is married to Steven L. Gilpatrick.


 

Anne Arney Adds Healthcare Expertise to Bone McAllester Norton

Anne Sumpter Arney, an experienced attorney in health care law, has become a partner of Bone McAllester Norton, Chairman Charles W. Bone announced today.

“Anne is one of the leading Nashville attorneys in health care law, and we are pleased to have her expertise and guidance in this area,” Mr. Bone said.  “Nashville is recognized nationally and internationally as a health care industry mecca with a local impact of nearly $30 billion and over 200,000 jobs.  We’re privileged to have Anne’s leadership in this ever-growing field.”

Ms. Arney has been practicing law for nearly 30 years, serving clients in general business and the health care industry.  Ms. Arney represents clients in matters ranging from general corporate to complex transactions.  She has extensive experience with the health care industry, representing businesses and health care providers in corporate, operational, and regulatory matters.

“I look forward to practicing law with Bone McAllester and Norton,” Ms. Arney said.  “I have had the opportunity to work with many of the attorneys at the firm and I know the high quality of services they provide to their clients.”

Ms. Arney is a member of the Nashville, Tennessee and American Bar Associations, the American Health Lawyers Association, and is a Fellow of the Nashville and Tennessee Bar Foundations.  She serves on the Board of the Nashville Bar Association and is a member of the American Bar Association’s Section on Health Law and the Tennessee Board of Medical Examiner’s Committee on Physician’s Assistants.

She has been a guest speaker on the topics of health care and corporate law for industry and professional associations and has authored a number of articles for medical and legal publications.

A native of Livingston, Overton County, Tennessee, Ms. Arney is an alumna of Vanderbilt University where she graduated cum laude with a bachelor of arts in English.  She received her law degree from Washington & Lee University School of Law in Lexington, Virginia.

She is married to Steven L. Gilpatrick.