Journal Record Staff Reporter
James Hall recently returned from a conference of the National Health Lawyers Association with 40 pounds of literature about the rapidly changing health care industry.
Hall, who earlier this month was elected president of the largest organization for attorneys specializing in health law, spends on average two hours a day reading about legal matters that affect health care.
His law firm, Crowe Dunlevy, has seen its health care section grow by an average of 25 percent annually during the past five years. Hall and five other Crowe Dunlevy attorneys specialize in health care cases, and another 20 attorneys provide support on health care deals when real estate, tax, antitrust, regulatory and labor issues arise.
"Health care is probably this country's biggest industry, and health law is a growing field. Health law requires a bit more currency than some other specialties because it is more dynamic. It moves rather quickly because there is so much government involvement in such areas as Medicare."
One recent change is an Internal Revenue Service ruling last month on tax-exempt status for nonprofit hospitals. The ruling affects how nonprofit hospitals recruit physicians. Hospitals who use lavish incentives to lure physicians in specialties that are not needed in the community could be in danger of losing their tax-exempt status, Hall said.
The trend toward managed care also requires knowledge of antitrust laws and rulings from the Federal Trade Commission and the U.S. Justice Department on vertical integration of entities.
"Managed care is a vertical integration. Because with managed care you are forming relationships that include some doctors and exclude others, you automatically are facing antitrust issues."
Even changes in state law can have a major impact on a health care deal. About three years ago, a new state law allowed for limited liability companies.
Several months ago, when the physician hospital organizations at four Oklahoma City hospitals combined into one "super PHO" the new entity opted to be a limited liability company. One reason: two of the hospitals were tax-exempt and two were for profit.
Because a limited liability is similar to a partnership, physician hospital organizations at each of the four hospitals …