Health Care

Highlights

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Verrill Dana was recognized by Acquisition International with 2016 M&A Awards for Best Healthcare Focused M&A Practice - USA and Best M&A Practice - Maine.
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Recognized as a Top Ranked firm in Chambers USA 2018.
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Recognized in the 2017 U.S. News - Best Lawyers "Best Law Firms" rankings.
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Verrill Dana's Health Care Group is proud to be a member and/or supporter of a number of significant health care associations.

Experience

We created and implemented an innovative health care benefit product for an association of employers creating a captive insurance company.
Has argued in excess of 20 appellate cases before the First Circuit Court of Appeals, the Massachusetts Supreme Judicial Court and Massachusetts Appeals Court.
Handled numerous postpayment audits by Medicare, Medicaid and private insurers.
To increase its competitiveness in a changing health care market, a leading Massachusetts academic medical center sought to build a more integrated health care network. The acquisition of another area hospital was a complex, multi-disciplinary effort spanning seven months.
Design and implementation of the response to a data breach caused by a third party vendor.
Developed a model fraud and abuse compliance program for the Massachusetts Medical Society and implemented numerous compliance programs for hospitals, medical practices, home health agencies and durable medical equipment suppliers. Mr. Shaw has also acted as compliance counsel to the Massachusetts Home Care Alliance and New England Medical Equipment Dealers Association.
Represented pharmaceutical manufacturers, academic medical centers and a pharmaceutical service company in connection with federal and state False Claims Act investigations and court actions.
In a case of first impression, successfully represented a neurologist sued by a consortium of health insurance companies for engaging in alleged illegal marketing practices on behalf of a national pharmaceutical manufacturer by promoting the off-label use of a major drug at medical education conferences. Following mediation, client was dismissed from the litigation.

Successfully defended at trial a multi-specialty medical group practice in a state court lawsuit against claims by a competitor for unfair competition and violation of the federal "Stark" law.
Represented a large Maine Hospital before the Medicare Provider Reimbursement Review Board covering four fiscal years. Following a live testimonial hearing, the MAC agreed to enter Administrative Resolutions addressing all years, resulting in over $6 million of additional Medicare reimbursement.
Represents The New England Journal of Medicine in a variety of mass tort litigations where the parties seek materials relating to scientific studies and articles published in the Journal. See, e.g., In Re Bextra And Celebrex Marketing Sales Practices And Product Liability Litigation, 249 F.R.D. 8 (D. Mass. 2008).
To expand its capacity to provide patient care in an increasingly competitive marketplace, a pioneering New York-based kidney and cancer research and treatment center affiliated with another New York institution in a complex, 11-month process requiring the coordination of many attorneys and practice groups.
We advised a health care entity with an employee who assumed the identity of a patient to obtain medications by inappropriately accessing the patient record system.
Frequently represent physicians and other health care professionals before licensing boards and during hospital peer review proceedings.
Successfully represented an acupuncturist against whom a complaint was filed with the Massachusetts Board of Registration in Medicine, Committee on Acupuncture, alleging, among other things, that she practiced outside the scope of her license and also engaged in wrongful and deceptive billing.
We drafted new bylaws following extensive discussions with board committees and the full board to assure that both the mission and governance structure of the organization were fully captured in the new bylaws.
This is an asset sale of the assets of a 501(3) tax exempt Medicaid managed care plan to a 501(c)(4) Managed Care Plan.
We negotiated physician compensation, transfer of major medical equipment that was subject to Certificate of Need review, and a wide variety of corporate issues in the sale of a long-time client's medical practice.
Sale of 500-bed teaching/community hospital to the teaching hospital of a major university.
Verrill Dana attorneys worked on behalf of our client to effect statutory changes to Maine law that would allow for the creation of one of the nation's first state-wide health information exchanges. 
We assisted and advised a client through the difficult process of an OIG self disclosure related to Medicare payments and the resident assessment process at a long term care facility.
In an appeal to the Medicare Provider Reimbursement Review Board (PRRB) in Baltimore, Maryland, Will Stiles represented a Vermont sole community hospital that experienced a sudden, but unexplained, decrease in the number of Medicare inpatients admitted during its fiscal year 2004. It had applied for a Medicare Low Volume Adjustment Payment, citing a 9.35% drop in inpatient volume from 2003 to 2004, and requested approximately $1.2 million of additional Medicare reimbursement. The Medicare program initially denied the hospital’s request in full because the hospital could not explain exactly why inpatient volume had decreased.
Represented lead intervenor Maine State Chamber of Commerce in complex administrative hearings before the Dirigo Health Agency (“DHA”) and Maine Superintendent of Insurance.
Represented Maine Medicare Dependent Hospital in an appeal before the Medicare Provider Reimbursement Review Board resulting in a $520,000 settlement.
Verrill Dana has a long history of helping methadone clinics in Maine, having helped permit the very first clinic in the mid-1990’s. In early 2011, a Massachusetts based provider of opiate addiction treatment services approached Verrill Dana for assistance in opening an outpatient Methadone treatment clinic in Sanford, Maine. On October 2nd, 2012, after more than 18 months of work, Verrill Dana succeeded in helping the client win approval from the Sanford Town Council to open a clinic.
Represented a Vermont sole community hospital in an appeal before the Medicare Provider Reimbursement Review Board resulting in a $430,000 settlement.
Represented nine Maine hospitals in administrative appeals and lawsuits against the State of Maine Medicaid program that resulted in a landmark $85 million settlement.
Represented two Maine hospitals in an administrative appeal of an alleged overpayment involving tens of millions of dollars over a six year time period, resulting in an agreement by the State of Maine Medicaid program that no overpayment actually occurred.