Healthcare Litigation

Medical partnerships begin with promise. Two physicians finish training and decide to build something together. A group of specialists pools resources and referrals to create something none could achieve alone. A founding physician brings in younger partners with the understanding that they will eventually take over. These arrangements work because everyone trusts everyone else. Often there is no written agreement, or the agreement that exists is a template pulled from the internet that does not reflect how the practice actually operates.

Then something changes. A partner stops pulling their weight but expects equal compensation. A founding partner treats younger physicians like employees rather than future owners.Disagreements arise over how to divide revenue, whether to invest in new equipment, or who makes decisions about the direction of the practice. The practice cannot continue with the conflict unresolved, but neither side wants to walk away from years of investment.

These disputes are deeply personal because they involve people you trusted. They are also financially complex because medical practices have unique economics. Revenue comes from multiple sourcesclinical care, ancillary services, facility fees, research. Expenses are allocated in ways that may or may not reflect actual resource usage. Partners have contributed different amounts of capital over different time periods. Untangling these threads requires understanding both the law and the business of medicine.

We handle partnership disputes by first understanding the economics of the practice. How have profits been distributed historically? What capital contributions has each partner made? What do the governing documents actually say, and do they reflect reality? We interview partners, review financial records, and trace where money has gone. We identify whether one partner has been enriching themselves at the expense of others, whether decision-making has been proper under the partnership agreement, and what each partner’s interest in the practice is actually worth.

When the relationship cannot be saved, we pursue buyouts, dissolutions, and accountings. We quantify the value of each partner’s interest, using forensic accountants when necessary. We negotiate separation terms that allow departing physicians to leave with what is theirs and remaining physicians to continue the practice without crippling debt. We ensure that departure does not trigger unfair restrictive covenants that prevent physicians from practicing in their communities.

Hospitals and health systems have become dominant players in the New York healthcare landscape. They employ thousands of physicians. They enter into exclusive contracts with specialty groups. They dictate the terms of participation for physicians who want to practice in their facilities. Their contracts are drafted by sophisticated legal departments and presented as non-negotiable. But when disputes arise, those contracts determine everything.

A hospital terminates your employment without cause, triggering a non-compete that prevents you from practicing within twenty-five miles of any facility in the system. A hospital breaches its promise to provide certain resources or support, leaving you unable to practice effectively while still bound by your agreement. A hospital initiates peer review proceedings that are really about terminating your privileges without paying what they owe under your employment contract. A hospital changes its compensation formula mid-year, reducing your income by tens of thousands of dollars.

We represent physicians in these disputes. We interpret the contracts hospitals draft and identify provisions that are ambiguous, unconscionable, or breached. We quantify the damages hospitals have caused by failing to perform. We negotiate resolutions that allow physicians to continue practicing or to leave under fair terms. When hospitals refuse to negotiate fairly, we file suit for breach of contract, seeking damages and declaratory relief.

These cases require understanding both contract law and the unique dynamics of hospital-physician relationships. Hospitals have enormous leverage—they control access to facilities, patients, and referrals. They also have obligations under their contracts and under the law. We hold them to those obligations.

Physicians increasingly face decisions about joining larger entities. A private equity firm wants to acquire your practice and roll it into a platform. A hospital system offers to buy your assets and employ you. A larger group wants to merge, promising economies of scale and administrative relief. These transactions are presented as opportunities to escape the business side of medicine and focus on patients.

The documents that govern these transactions are dense, complex, and written to protect the acquiring entity. They contain provisions that can limit your autonomy, restrict your ability to leave, and undervalue your contribution. They include representations and warranties that can expose you to liability long after the deal closes. They impose restrictive covenants that can prevent you from practicing if the relationship ends.

We review these agreements for physicians considering practice transactions. We identify the provisions that create risk. We negotiate better terms—higher valuations, more favorable compensation structures, narrower restrictive covenants, shorter non-compete periods. We push back on representations and warranties that could come back to haunt you. We ensure that you understand what you are signing before you sign it.

For physicians who have already completed transactions and find themselves in disputes with their new partners, we handle those disputes as well. Private equity firms and hospitals do not always deliver what they promise. When they fail to perform, we pursue claims for breach of contract, fraud, and other remedies.

The decisions physicians make when forming a practice have consequences for years. How should the practice be structuredprofessional corporation, limited liability company, partnership? How should ownership be allocated among founding physicians? What happens when a founder leaves or becomes disabled? How are new physicians brought in and how do they become owners? What restrictive covenants protect the practice without being overbroad?

We counsel physicians on these decisions at the beginning, before disputes arise. We draft partnership agreements, operating agreements, and shareholder agreements that reflect how the practice actually operates. We anticipate the disputes that commonly arise and build in mechanisms to resolve them. We address compensation models, governance structures, buy-sell provisions, and succession planning.

For physicians joining existing practices, we review the agreements they are asked to sign. We identify provisions that are unfair or unclear. We negotiate better terms. We ensure that incoming physicians understand their rights and obligations before they commit.

Non-compete agreements are standard in physician contracts. Hospitals require them. Practice groups require them. Even when you are leaving a practice you helped build, you may face a contract that purports to prevent you from practicing within a certain radius for a certain period.

New York courts enforce non-compete agreements against physicians, but only if they are reasonable in time, geographic scope, and the restrictions imposed, and necessary to protect legitimate interests. Courts also consider the public interest in access to physicians. A non-compete that would deprive a community of needed medical services is less likely to be enforced.

When you are subject to a non-compete, we evaluate its enforceability based on the specific facts of your situation. Where do you practice? What services do you provide? Are there other physicians in the community who can provide the same care? How broad is the restriction and how long does it last? We negotiate with the practice to modify or waive the restriction. If negotiation fails, we challenge the non-compete in court, seeking to invalidate it or limit its scope.

When you are bringing a physician into your practice, we draft restrictive covenants that are enforceable while being fair to the incoming physician. We define what constitutes solicitation of patients and colleagues. We tie the duration and scope of restrictions to legitimate practice interests. We ensure that the covenants reflect the realities of medical practice in your community.

Hospitals have medical staff bylaws that govern physician privileges and peer review proceedings. These documents create rights and obligations. When hospitals violate their own bylaws, physicians have grounds to challenge adverse actions.

We represent physicians in medical staff matters. When you apply for privileges and face unreasonable delays or denials, we advocate for fair consideration. When peer review is initiated, we ensure that the hospital follows its own procedures and that you have a fair opportunity to respond. When privileges are restricted or terminated, we challenge those actions through internal appeals and, when necessary, through litigation.

Peer review proceedings are often presented as collegial and educational, but they can be adversarial and consequential. The hospital may have its own agendareducing costs, eliminating competition, responding to pressure from administrators. We help physicians navigate these proceedings with their rights intact.

Every medical practice needs a buy-sell agreement that governs what happens when a physician retires, becomes disabled, dies, or simply wants to leave. Without such an agreement, transitions become disputes. The departing physician wants fair value. The remaining physicians want to pay as little as possible. There is no agreed mechanism for determining value or structuring payment.

We draft buy-sell agreements that anticipate these situations. We define how practice value will be determinedoften through agreed formulas or appraisal mechanisms. We structure payment terms that work for both departing and remaining physicians. We address what happens when a physician is terminated for cause versus leaving voluntarily.

When buy-sell disputes arise, we represent physicians on both sides. For departing physicians, we ensure you receive fair value for your interest. We challenge valuations that are artificially low. We pursue claims against partners who try to squeeze you out without fair compensation. For remaining physicians, we ensure that buyouts are structured in ways that do not cripple the practice financially.

Medical practices that operate without clear governance structures are prone to deadlock. Two physicians with equal ownership disagree on a major decision and cannot move forward. A three-physician practice has a 2-1 split that leaves the minority partner powerless. A practice with multiple owners cannot agree on whether to sell, merge, or bring in new partners.

We advise practices on governance structures that prevent deadlock. We draft agreements that include deadlock resolution mechanisms buy-sell provisions, tie-breaking procedures, mediation requirements. When deadlock occurs despite these mechanisms, we help resolve it through negotiation, mediation, or litigation.

Whether you are a physician just completing training or an experienced doctor considering a move, the employment agreement you sign will govern your relationship with your practice for years. These agreements cover compensation, call responsibilities, administrative duties, termination rights, and restrictive covenants.

We review employment agreements for physicians at every stage. We identify provisions that are unfavorable or unclear. We negotiate better terms. We ensure that you understand what you are signing before you sign it. We pay particular attention to compensation modelsare you being paid fairly for your work? To termination provisionscan you be terminated without cause and what happens then? To restrictive covenantscan you practice in your community if the relationship ends?For practices hiring physicians, we draft employment agreements that protect the practice’s interests while being fair to incoming physicians. We address compensation models, productivity expectations, partnership tracks, and what happens if the relationship does not work out.

Physicians increasingly face investigations related to billing and coding. The government alleges upcoding, unbundling, billing for services not rendered, or violations of the Stark Law and Anti-Kickback Statute. These investigations can be civil or criminal and carry enormous financial exposure, including treble damages and penalties under the False Claims Act.

We represent physicians in fraud investigations. When the government requests records, we manage production in ways that protect your interests. When investigators want to interview you, we prepare you and attend the interview. When charges are filed, we defend the case through trial.

These investigations often arise from whistleblower complaints filed by disgruntled employees, competitors, or patients. The government investigates many of these complaints. Not all result in charges. We help physicians navigate the investigative process and avoid charges where possible.

Medicare and Medicaid auditors routinely review physician billing. When auditors identify perceived overpayments, they demand repayment and may impose penalties. These audits can be stressful and time-consuming, diverting attention from patient care.

\We represent physicians in audit proceedings. We review the audit findings and the underlying documentation. We challenge conclusions that are unsupported. We negotiate repayment amounts when appropriate. We ensure that audit findings do not trigger broader investigations or referrals to law enforcement.

Physicians in group practice often disagree about financial matters. How are expenses allocated? Who decides whether to purchase expensive equipment? How are ancillary income streams from imaging centers, ambulatory surgery centers, or clinical research distributed among physicians?

We resolve these disputes by examining practice agreements, historical practice, and the reasonable expectations of the physicians involved. We negotiate resolutions that allow the practice to continue functioning. When necessary, we litigate to establish rights and obligations.

Physicians nearing retirement face complex decisions about how to transition out of practice. Selling your interest to younger partners. Arranging for practice continuation. Protecting your retirement assets from future practice liabilities.

We counsel physicians on transition planning. We structure sales of practice interests. We negotiate retirement agreements that provide income while protecting the practice. We ensure that you are not subject to ongoing liability after you leave. We address tail coverage for malpractice insurance, restrictive covenants that could limit your ability to consult or work part-time, and the tax implications of practice transitions.

Physicians come to us because we understand that their professional lives encompass far more than clinical care. They are business owners, partners, employers, contractors, and executives. Each of these roles carries legal implications. Each can generate disputes that threaten everything they have built.

We handle disputes across the entire lifecycle of medical practice. Formation and structuring when you start out. Contract review and negotiation when you join a practice. Partnership governance and dispute resolution while you are practicing. Buy-sell agreements and practice transitions when you leave. Acquisitions and mergers when you decide to sell.

We also handle the crises that arise unexpectedly. OPMC investigations that threaten your license. Peer review proceedings that threaten your hospital privileges. Fraud investigations that threaten your finances and freedom. Malpractice claims that threaten your reputation. Through it all, we remain focused on one thing: protecting physicians so they can continue practicing medicine.