Clinical Integration Attorneys: Advising Providers Structuring and Operating Clinically Integrated Organizations
Many providers are exploring or are in the formation stages of developing clinically integrated provider organizations. Health care attorney John Fisher has been counseling health care providers with respect to the creation of integrated provider networks as far back as 1992. He is versed in the current regulatory and antitrust requirements applicable to clinical integration, Accountable Care Organizations and managed care contracting under a variety of payment forms.
Health Care Attorney John Fisher has been representing physicians since the 1990s. John’s physician practice is broad ranging, but he is one of the few physician attorneys who has a long background in issues relating to provider integration. John formed some of the first integrated physician networks as far back as 1993 and has continued his work in clinical integration through the present time. In 1995, the Tampa Bay Business Journal referred to John as one of the most knowledgeable attorneys in the area of provider integration. John has maintained his active practice in that area and has followed the changes that have come through health care reform, Accountable Care Organization requirements, and other legal areas impacting integrated provider networks.
Additionally, John has a long history of representing provider groups in connection with negotiation of managed care contacts including a variety of payment methodologies. John gained experience negotiating some of the early capitated contracts between health plans and integrated provider organizations. John has also set up a variety of different provider incentive programs, withhold distribution models, bundled payment systems, and other provider reimbursement mechanisms.
John also brings a compliance component to his practice. He is one of the few physician attorneys who is certified in health care compliance. This background provides substantial benefit to John’s physician clients. He knows when a compliance issue exists and what to do about it. He also knows when false compliance issues are being put forth to gain negotiating advantage. John has experience that permits him to understand the nuances of the various laws that provide the regulatory framework in the healthcare industry. This knowledge often proves to be a significant benefit to John’s clients.
We are equipped to advise physicians and physician groups on the various laws that are applicable to the creation of practice associations and group practices and the requirements to become qualified as Accountable Care Organizations. We have also assisted physicians and physician groups in negotiating relationships with other providers such as hospitals, health systems, and ancillary providers.