The Patient Protection and Affordable Care Act, especially its provisions relating to Accountable Care Organizations (ACOs), presents unique challenges and opportunities for healthcare providers, managed care organizations and insurers. If successful, ACOs could result in a much more efficient healthcare delivery model, reducing utilization and costs while providing the best acute and long term care for patients. Prior to “starting an ACO”, each healthcare provider and supplier must initially evaluate their current status and readiness for the ACO world and determine if establishing or participating in an ACO is to their benefit. ACOs became part of the Medicare system on January 1, 2012.

Morris, Manning & Martin offers a multi-disciplinary approach to assist with meeting the challenges of determining provider organizations readiness for ACOs as well as advising on the tasks necessary to forming and managing an ACO. Bringing together experienced attorneys from our healthcare, corporate, insurance, tax and other practice groups, we can: 

• Evaluate the current state of your organization and its readiness for ACOs
• Assist in selecting the structure that best meets your needs based on business goals, tax considerations, financing, antitrust and other factors
• Effectively structure, negotiate and manage participation contracts, acquisitions, joint ventures, capital funding and other transactions necessary to  prepare your organization for ACO participation and develop and operate an ACO
• Establish fair and effective corporate governance and management procedures
• Negotiate vendor agreements necessary to implement clinical, administrative and healthcare IT systems
• Ensure compliance with the Stark Law, Anti-Kickback Law, Civil Money Penalty Law and other applicable state and federal regulations
• Obtain licenses and ensure compliance with state and federal laws governing risk-bearing entities
• Evaluate, negotiate and implement insurance arrangements, including captive insurance programs, to support ACO operations

Our attorneys have the deep expertise and experience necessary to help you plan, finance and implement a successful ACO. The areas of expertise we draw upon include the following:

Healthcare

Our Healthcare lawyers possess the experience and in-depth expertise to help clients properly structure their business relationships and transactions, comply with laws and regulations and achieve successful resolutions of any disputes and administrative proceedings that may result in this intensely regulated environment. Our team has extensive experience in assisting clients in selecting and forming the appropriate business entity(ies); adopting effective corporate governance and financial mechanisms; documenting contractual and other legal relationships; and developing and documenting joint ventures, mergers and acquisitions and other business relationships.

Corporate

With over thirty-five years of service to businesses throughout the U.S. and abroad, we have developed operations and best practices to efficiently and comprehensively provide counsel for virtually every corporate need such as corporate finance, governance, funding, complex partnerships and joint ventures, mergers and acquisitions, private equity transactions, restructuring and securities.

Insurance

Morris, Manning & Martin is well-known for its exceptional practice serving the insurance industry. Our practice spans the full gamut of corporate, regulatory, dispute resolution and securities matters faced by insurers, reinsurers, brokers, alternative risk programs and affiliated service providers. Our attorneys possess in-depth industry knowledge and experience navigating the complex legal environment in which insurance is transacted. 

Tax

Healthcare organizations, especially those utilizing tax-exempt entities, are subject to complex tax laws, especially on the federal level. Our lawyers have extensive experience forming and organizing tax-exempt organizations and obtaining federal and state tax-exempt status. We also provide continuing advice on maintaining and protecting tax-exempt status, including the tax consequences of an entity’s operations and activities ranging from sophisticated investment activities to participation in ancillary for-profit subsidiaries, joint ventures, technology transfers and other activities.