Health Care

Attorneys | Publications

Tydings is home to a team of experienced, talented health care lawyers, several of whom came from the ranks of the regulatory agencies before which we frequently represent clients.  Our diverse backgrounds and experiences allow us to handle all of our clients’ health care related legal matters -- from acquisitions to antitrust, long-term care to malpractice defense, fraud and abuse charges to regulatory compliance -- our lawyers have a track record of successful representation.

Regulation and reimbursement

Our health care attorneys are well versed in the laws and regulations that health care practitioners and providers confront every day.  Our lawyers have served as advisors and counsel to many of Maryland’s health care regulatory organizations.  Our breadth of experience helps clients better navigate the complexities of the Maryland health care regulatory system and the health occupations licensing boards.  We deal regularly with the Maryland Department of Health and Mental Hygiene (including the Office of Health Care Quality), the Centers for Medicare and Medicaid Services (formerly HCFA), Maryland Department of Aging, and other state and federal agencies.

We are also familiar with the intricacies of licensure, Medicare and Medicaid certification and reimbursement, disciplinary cases, and Maryland’s hospital rate setting and certificate of needs procedures.  Our clients include nursing homes, assisted living facilities, continuing care retirement communities, adult day care centers, and all other types of senior housing, hospitals, health insurance companies, managed care organizations, ambulatory care centers, pharmacies and pharmaceutical distributors, and other health care facilities and many types of health care professionals – all of which we have successfully represented before government agencies in matters involving licensing, certification, and more.

Tydings often serves as counsel and advisor in disciplinary cases and enforcement actions, including those before the Maryland Office of Health Care Quality, the Board of Physicians, and other health occupational regulatory boards.  We also represent clients in proceedings involving credentialing, peer review, and medical staff review.

Representative Matters

  • Litigated one of the two federal cases that convinced the Centers for Medicare and Medicaid Services to change a significant Medicaid regulation so that skilled nursing facilities would have the right to a hearing before an administrative law judge and full judicial review when nurses’ aide training programs are suspended;
  • Advocated on behalf of health care providers in license revocation actions;
  • Represented nursing homes in Medicaid reimbursement disputes;
  • Represented national and Maryland-based health care companies in obtaining exceptions to, and quick review of, licensing requirements from the Department of Health and Mental Hygiene;
  • Represented individual physicians and other health care professionals before licensing boards in disciplinary actions;
  • Represented long-term care facilities in survey and certification enforcement actions before the Maryland Department of Health and Mental Hygiene and the Centers for Medicare and Medicaid Services;
  • Defended senior housing and long-term care facilities facing imposition of civil money penalties;
  • Represented senior housing and long-term care facilities before the Office of Administrative Hearings on matters such as Medicaid reimbursement, involuntary discharges, Medicaid enrollment for residents, and imposition of sanctions;
  • Represented senior housing and long-term care facilities, ambulatory care and surgical centers, homes for the developmentally disabled, home health care agencies, and other types of health care facilities before the Office of Health Care Quality in all different types of regulatory procedures, including, but not limited to, initial licensure, preparing for surveys, drafting plans of correction, preparing for IDRs, case resolution conferences, imposition of deficiencies and sanctions up to and including license revocation and decertification from Medicaid and Medicare programs;
  • Represented a large Maryland-based pharmaceutical company in regulatory issues before the Maryland Board of Pharmacy; and
  • Advocated for various health care clients before the Maryland Health Care Commission and other health regulatory boards established by the State of Maryland.

Business and legal strategies

Health care law today encompasses many different practice areas.  Tydings offers a full spectrum of legal services to integrate seamlessly the varied needs of our health care clients.  We routinely help clients:

  • Structure practices in the most strategic and tax-efficient manner possible, whether as partnerships, limited liability companies, or corporations;
  • Protect their interests in mergers or joint ventures with other health care practices, in acquisitions by other groups, and in purchases of other practices;
  • Review staff employment agreements, partnership agreements, and other contracts;
  • Establish integrated delivery systems, physician practice groups, and other health-business arrangements;
  • Acquire land, seek zoning approvals, and secure financing for various projects;
  • Finance and develop health care facilities, including those serving the fast-growing senior housing market;
  • Structure employment benefits, contracts, and compensation;
  • Resolve employment disputes;
  • Manage corporate governance and compliance; and
  • Interact with the state legislative and executive branches on matters such as the revision of Maryland’s Assisted Living laws.

Representative Matters

  • Drafted resident agreements, policies and procedures, and other documents for CCRCs, nursing homes, assisted living facilities, and other health care providers to ensure regulatory compliance and avoid legal liability;
  • Represented the largest speech pathology practice in Baltimore in its acquisition by Sylvan Learning Systems, Inc.;
  • Represented national and Maryland-based corporations, including the nation’s largest owner of assisted living facilities, in acquisitions and sales of facilities in Maryland;
  • Reconfigured the Operating Agreement for a large ambulatory surgical center to maximize compliance with the Stark law provisions and anti-kickback laws;
  • Represented company that owns several nursing homes throughout Maryland in acquisition of land for expansion from Baltimore City government;
  • Assisted physicians and other entities in establishing ambulatory surgery centers; and
  • Counseled physicians and physician groups in mergers and acquisitions, succession planning, employment agreements (including non-compete covenants), and deferred compensation agreements.

Litigation

Tydings represents health care clients in a broad range of proceedings.  We have successfully challenged state and federal Medicaid enforcement procedures, including a case in which a key Medicaid regulation was overturned.  Our litigators also have extensive experience in malpractice defense in Maryland, the District of Columbia, and Virginia representing individual physicians and health care companies.  We routinely represent and defend clients in matters including:

  • Medical malpractice claims;
  • Injunctive actions and challenges to administrative rules;
  • Product liability cases;
  • Personal injury claims;
  • Insurance coverage disputes;
  • Commercial tort and contract claims, including check and health care fraud;
  • Nursing home and other senior housing facility bankruptcies;
  • Employment litigation matters; and
  • Business disputes.

Representative Matters

  • Represented a company that owned over 40 nursing homes in a receivership case in which our lawyers put the client into an voluntary receivership, sold off the remaining assets, handled all the outstanding Medicare and Medicaid cost report settlements for the nursing homes going back as far as a decade, litigated a wide of variety of issues affecting the receivership estate, and ran the entire claims process involving a number of creditors;
  • Represented a pharmacy in $5 million prescription misfill case where during deposition, the plaintiff’s expert conceded that the misfill did not cause the plaintiff’s condition, but rather admitted that the plaintiff’s medical problems were due to an unrelated, pre-existing medical condition.  The case resolved favorably shortly thereafter; and
  • Represented a pharmacy in a premises liability where the plaintiff claimed to have contracted fibromyalgia after being struck by a malfunctioning door.  On a motion in limine, the court excluded the plaintiff’s expert testimony because there is no medical literature linking trauma to fibromyalgia.  Despite conceding liability, the jury returned a $0 verdict.

Leadership

Attorneys at Tydings are active members of many health care-related organizations, including the American Association of Nurse Attorneys, American Bar Association-Health Law Section, American Health Lawyers Association, American Society for Healthcare Risk Management, Center for a Healthy Maryland, DRI-The Voice of the Defense Bar, Health Facilities Association of Maryland, LifeSpan Network, Inc., Maryland Defense Counsel, Maryland-DC Society for Healthcare Risk Management, and Med-Chi.

Representative Clients

We have represented or currently represent these clients in the health care field:

  • Aureus Group, LLC
  • Brightview Senior Living, LLC
  • CVS of Maryland, Inc.
  • Dulaney Eye Institute, LLC
  • Fountain Square Properties LLC
  • Friends House Retirement Community
  • Greater Baltimore Medical Center, Inc.
  • Holly Hill Manor, Inc.
  • Ivy Hall Geriatric & Rehabilitation Center, Inc.
  • Landow House and Ring House of Hebrew Home of Greater Washington
  • Maryland Masonic Homes
  • Prime Care Properties, Inc.
  • Quail Run Elder Care Communities
  • Roland Park Place
  • Sunrise Senior Living, Inc.
  • White Oak Senior Care LLC

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