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With one of the largest and most influential health law practices in Northern
New England, Preti Flaherty is the recognized leader in Maine health care
matters. We represent the full range of health care providers, including
hospitals, nursing homes, home health agencies, rehabilitation centers and other
health care facilities, as well as insurers and individual practitioners. As
counsel to the Maine Hospital Association and the Maine Health Care Association,
we work hard to adjust regulations and advance laws and interpretations in
support of our clients' interests. We are the unquestioned authority on emerging
health care issues and their legal ramifications.
We provide services such as:
- Obtain Certificate of Need approval for institutions facing increasingly
complex state regulatory issues
- Assist with licensing and compliance with regulatory and accreditation
requirements
- Represent hospitals at hearings and proceedings before the Department of
Human Services
- Assist with malpractice claims, medical staff disputes and complaints of
employment discrimination directed against hospitals and other providers.
Representative Matters:
- Counsel to Mercy Hospital in securing an $85 million Certificate of Need
from the Maine Department of Human Services to build a state-of-the-art facility
on the Fore River in Portland that will house short-stay surgery, outpatient
services and Mercy’s Birthing Center.
- Represented Genesis HealthCare, one of the nation’s largest providers of
long-term health care and support services to the elderly, in obtaining its
Certificate of Need approval to enter into a long-term lease to operate 11
nursing facilities previously operated by Sandy River Health Systems. Worked
closely with officials of the Maine Department of Health and Human Services, and
assisted Genesis in meeting the detailed standards for obtaining the CON. The
CON also approved a purchase option.
- Prevailed in a federal administrative law hearing before a Cleveland Ohio
judge on behalf of a Maine osteopathic physician, Judy Hetzler Shedd, D.O.
The Judge concluded that the regional Medicare carrier had improperly recouped
payments for hundreds of osteopathic procedures performed by Dr. Shedd and
restored these funds to her. The court rejected the carrier’s denial, based on a
1994 local coverage determination. The administrative law hearing was the
third level appeal, following reviews by Massachusetts and Florida Medicare
entities, where Dr. Shedd had been denied relief.
- Worked successfully on behalf of Acadia Hospital and Spring Harbor Hospital,
Maine's two non-profit psychiatric hospitals to obtain enactment of supplemental
appropriation of $5.6 million to treat indigent mentally ill patients.
Handled legislative approval of the appropriation necessary to make up for
significant shortfall in so-called disproportionate share of hospital (DSH)
Medicaid pool.
- Worked with Franklin Memorial Hospital to secure needed approvals to permit
transfer of $16 million in investment funds from the hospital to its parent, the
Franklin Community Health Network, a national award winner for its
community health programs. Approvals were secured from the Maine
Attorney General and a Franklin County Superior Court Justice. This change
will provide the Hospital and its parent with greater flexibility to
fulfill community needs.
- Represented a consortium of three Maine hospitals – Maine Medical Center,
Southern Maine Medical Center and Goodall Hospital– in obtaining Certificate of
Need approval for a radiation treatment facility in South Sanford, the Cancer
Care Center of York County (CCCYC). Because two other hospitals were also
seeking approval in a competitive review, the hearings and other proceedings
before the Department of Human Services were hotly contested. Several court
appeals followed in which the CCCYC has prevailed.
- When Great Northern Paper (GNP) filed for bankruptcy protection, its
self-funded employee health care plan was in jeopardy. We worked with GNP, the
Governor’s office, major health care providers and creditors to create and fund
an interim health program to preserve employee coverage and make GNP more
attractive to prospective purchasers. The federal bankruptcy court approved the
interim health care funding protocol, assuring employees, retirees and their
dependents continued health care until the company was sold.
- Represented Rumford Community Hospital when it sought additional Medicare
payments to help recover from an economic downturn and physician recruitment
problems, Medicare denied the request. Our lawyers worked with the hospital to
appeal to the federal Provider Reimbursement Review Board in Baltimore. After a
full hearing, the Board reversed the initial Medicare decision and awarded
hundreds of thousands of dollars in additional reimbursement.
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