How big is our practice group?
64 lawyers (18 partners, 3 counsels, 42 associates).

What do we do?
As one of the leading health care practices in the country, Ropes & Gray helps its clients navigate a broad range of complex regulatory and business demands. Our more than 60 professionals represent virtually every sector of the global health care industry, including health care investors and financial institutions, academic and community hospitals, medical schools, pharmaceutical companies, pharmacy benefit managers, medical device companies, insurance companies, health care provider organizations, physician practice groups, health care technology companies, biomedical companies, and long-term care and nursing home providers.

Ropes & Gray’s Health Care Practice provides a comprehensive range of services, including:

Regulatory & Compliance

• Medicare, Medicaid and third-party reimbursement
• Federal health care regulatory issues (e.g., FDA, Stark, Antikickback, HIPAA, IRB)
• Clinical research
• Fraud and abuse
• Privacy and data security
• Antitrust
• Licensure
• Public health oversight
• Intermediate sanctions
• Government enforcement

Transactional & Capital Finance

• Mergers and acquisitions
• Disaffiliations and separations
• Joint Ventures and partnerships
• Affiliations, research collaborations, and licensing agreements
• Revenue development
• Complex commercial agreements
• Tax exempt bond financing

Strategic Counseling

• Governance and fiduciary standards
• Health plan representation
• Payor contracting
• System network and design
• Public policy initiatives
• Government relations
• Strategic positioning
• Organizational structure
• Physician integration
• Accountable Care Organization Development

• We represented Harvard Pilgrim Health Care, Inc. (“Harvard Pilgrim”) in its discussions with Tufts Associated Health Maintenance Organization, Inc. regarding a potential merger.  We advised Harvard Pilgrim on strategic and legal considerations for structuring the transaction and the governance of the surviving entity.  We also assisted Harvard Pilgrim in the negotiations of the Memorandum of Understanding and Merger Agreement between the parties.  We conducted extensive analysis of the relevant regulatory approvals, performed an initial diligence review, and advised on related tax and other legal issues.  After the parties determined not to proceed with the merger, we further advised Harvard Pilgrim on the wind-down process for the parties’ discussions.
• We successfully negotiated a settlement for Massachusetts General Hospital (“MGH”) in one of the first significant HIPAA enforcement actions undertaken by the United States Department of Health and Human Services, Office of Civil Rights (“OCR”) relating to the loss of certain documents containing protected health information by an employee.   In the context of this matter, we advised MGH with respect to investigation of the incident, legal issues arising under the HIPAA privacy, security and enforcement rules, negotiation of the settlement in light of existing precedent, and implementation of a corrective action plan as part of the OCR settlement.
• We secured a significant victory on behalf of Harvard Pilgrim Health Care, Inc. (“Harvard Pilgrim”), a full-service health benefits company serving members throughout Massachusetts, New Hampshire, Maine and beyond, in connection with its offerings in the individual and small-group health insurance market.  Following the issuance of emergency regulations in February 2010 at Governor Patrick’s request, the Massachusetts Commissioner of Insurance disapproved a total of 235 health insurance premium rates proposed by six insurance carriers, including all but one of the premium rates proposed by Harvard Pilgrim. On behalf of Harvard Pilgrim, we appealed this decision to an administrative panel consisting of three Division of Insurance (“DOI”) hearing officers.  The DOI’s Health Care Access Bureau opposed our appeal, and the Attorney General intervened in the proceedings.  The three-member panel of hearing officers issued a decision reversing the previous disapproval of Harvard Pilgrim’s proposed premium rates.
• We serve as general and legislative counsel to the National Association of Public Hospitals and Health Systems (“NAPH”). We represented the interests of NAPH members and the vulnerable patient populations they serve in the health reform debate, working closely with key House and Senate leadership to include several provisions critical to safety net providers, including moderation and restructuring of changes to Medicaid and Medicare Disproportionate Share Hospital payments and the establishment of a new Community-Based Collaborative Care Network program.  Upon passage of the legislation, Ropes & Gray embarked on an intensive education campaign for NAPH members, providing summaries, analyses and timelines of the legislation, conducting a series of eight webinars for NAPH members on various aspects of the bill, and presenting and facilitating discussions at conferences and meetings on the legislation.  At the same time, we have commented on behalf of NAPH on various reform-related regulations and guidance, including regulations implementing HIT incentive payments, implementation of Medicare payment provisions in PPACA, the establishment of health insurance exchanges, and guidance on the federally qualified health center program.
• We represent the University of Southern California (“USC”), a major research and teaching institution with a nationally recognized medical school and clinical faculty. In furtherance of USC’s vision to operate a fully integrated health system on campus, USC acquired its two teaching hospitals, USC University Hospital and Norris Cancer Hospital, from Tenet Healthcare Corporation. We advised USC on the health care regulatory, tax, employee benefits and environmental aspects of the $275 million acquisition, which included 471 in-patient beds and 1,600 hospital employees. We also provided advice to USC regarding the restructuring of the University’s relationship with its 20 faculty practice plans.
• We served as health care regulatory and litigation counsel to Express Scripts in connection with its 2009 acquisition of Wellpoint, Inc.’s NextRx pharmacy benefits management (“PBM”) division for $4.68 billion in cash and stock. The acquisition represents a major development in the PBM industry as it combines the businesses of the third and fourth largest PBMs in the country and boosts Express Scripts’ client base by approximately 25 million people. 
• We advised the Qatar Foundation for Education, Science and Community Development in connection with the establishment and organization of a specialty teaching hospital to be located in Doha, Qatar. The facility, a state-of-the-art, all-digital medical and research complex, will serve as the principal teaching hospital for Weill Cornell Medical College’s branch campus in Doha. Weill Cornell established its branch campus in Doha as part of an agreement with the Qatar Foundation. Our work for the Qatar Foundation involves advice on organizational structure; corporate governance matters; institutional policies concerning clinical care; medical staff relations; human subjects research and research compliance and intellectual property ownership and commercialization; complex vendor relationships; and the teaching affiliation agreement being negotiated with Weill Cornell Medical College. We also advise the Qatar Foundation on its relationship with Cornell University and with several of the other universities that have established or are considering establishing branches campuses in Qatar. 
• We represented the plaintiffs — Association of American Medical Colleges, American Hospital Association, National Association of Public Hospitals and Health Systems, and Alameda County Medical Center — in a lawsuit against the U.S. Department of Health and Human Services (“HHS”) challenging challenging a federal Medicaid rule that would have resulted in cuts of billions of dollars for the impacted hospitals. The rule aimed to restrict Medicaid payments to public providers and dramatically narrow the definition of units of government for purposes of Medicaid financing. The District Court for the District of Columbia granted summary judgment for our clients, ruling that HHS had issued the rule in violation of a Congressional moratorium. In issuing its opinion, the court emphatically embraced our characterization of the rule: “In this case, the Court is asked to decide whether a maneuver by the Executive Branch deliberately designed to outfox a clear directive of Congress was successful…. The answer is no.” Alameda County Medical Center, et al. v. Leavitt, 559 F.Supp.2d 1.
• We advise major pharmaceutical manufacturers on compliance with federal and state anti-kickback statutes, the Pharmaceutical Research and Manufacturers of America “Code on Interactions with Health Care Professionals,” state laws on pharmaceutical marketing such as the California Drug Marketing Law, and the companies’ own policies.  For one client, we have been asked to conduct a legal review of virtually every educational grant request submitted to its largest divisions.  In addition, we have seconded several attorneys to serve as in-house counsel for up to six months to assist our clients in reviewing materials and policies to ensure regulatory and fraud and abuse compliance.
• We represent numerous clients in response to government investigations of client operations, Medicare and other health care program billing procedures, reimbursement for clinical and scientific research, business practices and contractual relationships with physicians and other referral sources.
• We assist health care clients regarding preparation for the response to natural disasters, including the development of policies, procedures and agreements to ensure the continuity of health care services and the security of health care information in the event of disaster.