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Overview

Health law is an incredibly diverse area of practice which does not focus on a singular type of legal work. Attorneys in this field focus on the health industry in general, but the types of work available vary widely. Some lawyers counsel health care entities on a range of transactional and regulatory matters, including mergers and acquisitions and joint ventures. Others handle any litigation-related matters that arise for their health care industry clients. Some lawyers focus on compliance issues, ensuring clients are adhering to regulations and laws and conducting internal investigations for clients, while others work on the government side, enforcing regulations. This area is an exciting one because it is constantly evolving and changing, especially when it comes to digital health. Lawyers focusing on digital health may work on IP-related matters, privacy and data security, regulatory issues, policy research, and more. On the nonprofit side, lawyers may work for an organization that promotes public health, access to health care, advocacy for a specific health issue, etc. Clients in the health law arena range from hospitals and medical centers to insurance companies and pharmaceutical entities to laboratories and private equity funds—plus many more.

Featured Q&A's
Get an insider's view on working in Health Law from real lawyers in the practice area.
Alexis S. Gilroy, Partner
Jones Day

Describe your practice area and what it entails.

In short, I am a health regulatory attorney with a significant trans-actional background enabling me to structure, negotiate applicable documentation for, and advise clients on various multi-jurisdictional health regulatory strategies for advancing digital health services. This involves working with hospitals, health systems, global retail and pharmacy organizations, life science companies, investors, technology and big-data companies (large and small), and emerging virtual care networks in various transactional ventures, compliance counseling needs, and advice pertaining to regulatory investigations.

What types of clients do you represent?

My historic client base includes investors and health care providers of all types (hospitals, health systems, and virtual care or telehealth organizations) operating in the U.S. and abroad. However, as digital health opportunities evolve and health care needs spark the interest of many non-traditional participants, I am increasingly working with device manufact-urers, technology and big-data companies, large global retail organizations, e-commerce networks, and life sciences institutions as well.

What types of cases/deals do you work on?

My client work involves various digital health topics, including evaluating multijurisdictional strategy and implementation given various jurisdiction-specific health, data, reimbursement, and fraud regulations and requirements. I frequently develop and negotiate telehealth-specific services and affiliation contracts and manage health regulatory matters for M&A and equity transactions with both investor/buy-side and company/target-side experience. I’ve assisted retail organizations such as Wal-Mart and Walgreens in digital health pursuits, while providing support on various telehealth regulatory and transactional matters to the likes of Cleveland Clinic, Dignity Health, Houston Methodist, Loma Linda, Northwell Health, UPMC, and a number of other hospitals and health systems. My work with new “all virtual” emerging companies—such as Specialists on Call, Onduo, PWNHealth, Ro Health, and Nurx—is particularly interesting and novel, as we assist clients in standing-up national telehealth operations compliant with all applicable state health care laws and requirements, while also negotiating and documenting arrangements with various customers and providers across the U.S.

How did you choose this practice area?

Thanks to a long-standing passion for and interest in health policy, my senior-associate years found me managing numerous M&A and finance transactions for various early digital health and telehealth businesses. The relationships with these emerging companies, as well as their energy and promise, were compelling. I was hooked and wanted to be part of the digital health transformation. It was a very natural transition to digital health on a full-time basis. Digital health allows me to pair a background in transactional practice (often requiring a keen understanding of the business motives driving health care deals) with a subsector of health law mired in evolving business-oriented policy at the federal, state, and international levels.

What is a typical day like and/or what are some common tasks you perform?

A typical day finds me fielding multiple calls with clients, evaluating research on various state and international health regulatory topics for application to a particular client’s novel virtual care offering, marking up contracts for client’s proposed partnership or acquisition given health regulatory considerations, and meeting with team members from our U.S. and international offices to consider unique regulatory questions for various digital health clients. I enjoy the ability to grow relationships with many different colleagues and clients and the constant learning advances our collective experiences to advise clients better on novel topics. Every day, I get to help clients solve new and interesting challenges to advance health care needs for consumers around the globe, working with colleagues who are engaged and extremely talented. We are playing a role in advancing what’s possible in health care delivery. What could be better?

What training, classes, experience, or skills development would you recommend to someone who wishes to enter your practice area?

Classes in health law, technology law (including intellectual property topics), and cybersecurity, along with any practical business planning or transactional-oriented classes or clinics, would help build the foundation for a practice in digital health law. I found my classes with adjunct professors to be especially helpful for practicing in a transactional area. A course in accounting or on health policy is also likely to provide useful perspectives.

What is the most challenging aspect of practicing in this area?

Digital health is constantly evolving, and while this is intellectually stimulating, it necessitates a commitment to tracking the stakeholders and the underlying business trends and policy-driving motives in the sector. Over the years, I’ve found that the most fulfilling way to manage this is to jump in and engage with health-care-sector groups (not necessarily law oriented). Sometimes just showing up and volunteering will yield leadership opportunities. The insights and practical education you gather from industry meetings and publications are amazing, and the relationships you develop in these settings are tremendous and provide fulfilling connections to expand your referral network and resources for questions and mentoring. While the time involved in these professional development activities isn’t typically billable or specific to one client, the returns, in terms of the level of guidance you are able to provide to clients, are priceless.

What misconceptions exist about your practice area?

Health care is a multifaceted industry with many players and incentives, and I wish I had understood in more detail the various stakeholders and their motives early in my career. While there are certainly health-care-specific laws and regulations unique to this sector, a practice in health care is an industry-focused practice more than a legal-skill-specific practice; thus, a keen understanding of the health care industry is critical. Attorneys with provider, payor, or health care administrative exposure prior to law school have unique insights into the operational issues within the industry—a topic valuable to any health care attorney.

What is unique about your practice area at your firm?

Jones Day is truly a team-oriented law firm, which is very fulfilling for a professional and essential to a digital health practice, since working in this sector often necessitates collaborating with IP, corporate, finance, and international colleagues. Given the transformational opportunity within digital health, it is truly satisfying to collaborate in a legal practice environment on the cutting edge, with partners who care deeply about supporting our clients in their endeavors.

What are some typical tasks that a junior lawyer would perform in this practice area?

Junior lawyers are the foundation of our digital health team. Given the multi-jurisdictional research necessary for various digital health projects, junior lawyers are frequently involved in researching and considering novel questions of state or international health and data privacy regulation. Given these research projects often involve teams of associates, they often enjoy and experience the collaborative nature that is a true hallmark of practice life at Jones Day. Notably, as the digital health sector remains an area of ongoing legal and policy interpretation—similar to other topics our attorneys are trusted to handle firmwide—associates, even the most junior, benefit from teaming side-by-side with partners on the application of health regulatory and data privacy research to collectively advance novel legal constructions applicable to not only client interests but also an evolving body of health law and policy.

Alexis S. Gilroy, Partner—Health Care

Alexis Gilroy, a national leader in the digital health industry, advises on complex transactional and health regulatory issues, with an emphasis on virtual care topics. Focused on transactions in the digital health sector for more than a decade, Alexis pairs practical experience with a keen understanding of novel federal and state regulatory requirements. Hospitals, health systems, and other health care providers across the U.S., as well as telehealth companies, technology organizations, e-commerce, pharmacy and retail leaders, life sciences businesses, and investors seek her legal counsel on various digital health topics, including multijurisdictional business strategy and implementation, state-specific telehealth regulation, corporate practice of medicine, reimbursement, international programs, online prescribing, patient consent, remote supervision, and fraud and abuse considerations.

Alexis speaks and writes extensively on matters involving digital health and has testified before legislative and regulatory bodies. A member of the board of directors of the American Telemedicine Association and current vice president, she was an appointee to the Maryland Governor’s Telemedicine Task Force, a member of the Federation of State Medical Boards’ Workgroup on Telemedicine, and leader of the American Health Lawyers Association’s Telemedicine and E-Health Affinity Group.

Ashley M. Fischer, Partner • Marshall E. Jackson, Jr., Associate
McDermott Will & Emery LLP

Describe your practice area and what it entails.

Ashley: I collaborate with health industry stakeholders on a broad range of corporate and regulatory matters. My antitrust work includes assessing the implications of the formation and operation of competitor collaborations, merger analysis and defense, compliance, and ordinary course conduct. I served as partner-in-charge of McDermott’s Health Industry Advisory practice group in Chicago from 2015 to 2018, and I currently serve on the firm’s Management Committee.

Marshall: My practice is twofold. I provide transactional and regulatory counseling to a variety of clients in the health care industry, as well as advise on the full spectrum of legal, regulatory, and compliance issues related to digital health—
the intersection of health software applications, analytical tools, medical technology, and electronic data assets enabled by the internet and mobile devices—with a particular focus on telehealth, telemedicine, mobile health, and consumer wellness.

What types of clients do you represent?

Ashley: I exclusively represent businesses, associations, and professionals in the health care industry.

Marshall: I work with hospitals and health systems, private equity firms and their portfolio companies, technology companies, post/sub-acute providers, physician practices, and other public and private health care companies on a variety of complex transactions and health regulatory compliance matters.

What types of cases/deals do you work on?

Ashley: I defend mergers among participants in the health care industry and advise clients on the potential antitrust implications of transactions they are considering. I provide corporate and antitrust counsel to managed care contracting networks—such as clinically integrated networks (CINs), accountable care organizations (ACOs), physician-hospital organizations (PHOs), and independent practice associations (IPAs)—in their formation and operation. I also offer corporate and antitrust counsel to provider collaborations and joint ventures—including quality and/or cost-sharing initiatives, joint purchasing arrangements, and co-marketing arrangements—as well as to trade associations regarding their formation and operation.

Marshall: I advise on all aspects of health care transactions, including mergers, acquisitions, joint ventures, and strategic affiliations. I also advise clients on federal and state health care regulatory issues, including fraud and abuse compliance, reimbursement, behavioral and mental health regulatory compliance, licensure, and operational matters. My digital health engagements include assisting clients in developing and implementing telehealth programs by advising on state and federal compliance issues related to licensure, scope of practice, informed consent, and reimbursement, as well as prescribing.

How did you choose this practice area?

Ashley: Prior to law school, I was a legislative aide covering health issues on Capitol Hill. I liked that the health industry was dynamic and ever changing, so I decided to pursue health law.

Marshall: Prior to law school, I served as a medical service corps officer in the United States Army. I always wanted to practice law, and by merging my experience in the Army and my passion to practice law, practicing health law was a natural progression. I began my career doing health regulatory and transactional work. I really liked both and understood the need for a depth of regulatory knowledge in transactional work. Additionally, I had a mentor who was involved in digital health, and I found the digital health work particularly interesting. Early in my career, I noted that there were not many lawyers focusing on digital health at the time, and I saw an opportunity for growth. I have continued to expand both my transactional and digital health practice.

What is a typical day like and/or what are some common tasks you perform?

Ashley: There’s not a typical day in my work, which is what makes it fun. There is always a new transaction, development, and regulation presenting new and unique issues. Every day is a new adventure.

Marshall: Because my practice spans a few focus areas, I get to see many different aspects of health law. For clients considering transactions—including digital health transactions—I negotiate and draft definitive and ancillary agreements on various deals and collaborations and advise clients on key transactional risk areas. For example, if a private equity firm is investing in a physician practice, I will advise on the risks while also drafting and negotiating the purchase agreements and managing other aspects of the deal. For digital health, I advise clients on various state regulatory requirements and assist providers in establishing telemedicine programs and related compliance protocols.

What training, classes, experience, or skills development would you recommend to someone who wishes to enter your practice area?

Ashley: Health industry experience is truly important for someone wanting to work in health law. You need the hands-on industry experience to best be able to serve your clients. There are a number of different paths you can take to do that, but you should have some health background. For example, you could take contracts courses specific to the health industry, or you can gain experience by working at a hospital or health company. It is an industry practice, so you need to understand how the industry works in order to guide clients—your legal advice will only be as good as your knowledge of the industry.

Marshall: For anyone looking to practice health law, I first recommend you remain open to taking on projects outside of what you think you want to do. Get experience on various deals and matters. You may think you really want to practice in one area of health law, but find interest in something else. By being open to various projects and experiences early, not only will it help you identify what you like doing within health law, it will also allow you to see common threads across industry sectors. You will only start noticing cross-disciplinary trends by working on different projects.

I would also recommend seeking out and attending training opportunities or conferences that focus on your areas of interest. These opportunities may be internal to your firm or company, but may also be industry-provided conferences and training. I attend various conferences internal to Mc-Dermott, such as the Physician Practice Management &
ASC Symposium. The American Telemedicine Association has great telemedicine events, and the American Health Lawyers Association provides excellent industry conferences.

What is the most challenging aspect of practicing in this area?

Marshall: The health industry continues to constantly shift and change. On the transactions side, there are many new players coming into the market. Transactions are no longer just physician-to-physician or hospital-to-hospital—we’re now seeing tech companies collaborating with providers or payors, and these new deals create complexity and new deal dynamics. Staying up to date on the digital health side is an exciting challenge as well. The technology moves so fast that the laws can’t quite keep pace. For me, the most challenging aspect is also what I love best: the challenge of the ever-changing environment. Getting to new outcomes is exciting and keeps you fresh and always learning.

What is unique about your practice area at your firm?

Ashley: What is interesting about health care is that it is always changing. There is always new guidance and regulations. At McDermott, we field multidisciplinary, cross-border teams to propel the success of our clients across the industry, from tech companies developing ground-breaking digital health applications to health systems pursuing innovative partnerships. We’re the leading health care firm in the U.S.—our Health Industry Advisory group is the only health practice to receive top national rankings from US News–Best Lawyers “Best Law Firms,” Chambers USAThe Legal 500 United States, and Law360.

What kinds of experience can summer associates gain in this practice area at your firm?

Ashley: Our summer associate program gives participants hands-on experience and tailored mentoring in both group and individual settings, plus extensive training through McDermott University. It is a great way for law students to gain practical, firsthand experience in health care law. Because our firm operates at the cutting edge of the health industry, summer and other junior associates have unique opportunities to develop experience and skills in new and emerging focus areas. I was a junior associate when HIPAA first came out, and I was able to build a deep knowledge base around that. Getting early industry exposure through McDermott’s summer associate program is a great way to start building your own health law practice.

How has the digital health market affected your practice?

Marshall: I spend a fair bit of my time on digital health work. Digital health is continuing to grow across the health industry. Everyone is looking to connect with consumers where they are through digital technology. Telemedicine, for example, allows you to connect with your doctor at work or at home, and with that comes new and different state and federal regulations. I have to understand those regulations so I can counsel companies effectively. I also do a lot of work counseling new nontraditional market players on how they can work in this ever-shifting space.

Ashley M. Fischer, Partner, and Marshall E. Jackson, Jr., Associate—Health Care

Ashley M. Fischer counsels clients on the full range of corporate and regulatory issues facing health care clients today. She advises on affiliations, collaborations, health reform initiatives and alignment strategies, joint ventures, and managed care contracting networks—such as clinically integrated networks (CINs) and accountable care organizations (ACOs). Her broad antitrust experience includes merger analysis and defense, assessment of competitor collaborations (from formation through to daily operations), compliance, and ordinary course conduct. Ashley served as partner-in-charge of the firm’s Health Industry Advisory practice group in Chicago from 2015 to 2018 and currently serves on the firm’s Management Committee.

Marshall E. Jackson, Jr., collaborates with stakeholders across the health care industry to meet their transactional and regulatory goals. He counsels hospitals and health systems, private equity firms and their portfolio companies, post/sub-acute providers, physician practices, and other public and private health care companies in complex transactions and health regulatory compliance matters. Marshall also offers clients guidance on the rapidly developing legal, regulatory, and compliance aspects of digital health, including telehealth; telemedicine; mobile health; and consumer wellness, and related issues such as professional licensure, scope of practice, informed consent, and reimbursement, as well as prescribing.

Elizabeth Kolbe, Associate • Neil Nandi, Associate
Sidley Austin LLP

Describe your practice area and what it entails.

Sidley’s health care practice counsels clients in the heavily regulated health care industry. Sidley’s health care lawyers defend clients in government investigations; try civil cases; counsel clients on pricing, reimbursement, fraud and abuse, compliance, HIPAA/HITECH privacy, transparency, and antitrust issues; advocate on behalf of clients before the Department of Justice, FDA, HHS, the FTC, Congress, and other state and federal regulatory agencies; and help assess regulatory risk in transactions.

What types of clients do you represent?

Sidley’s health care practice advises clients throughout the health care industry, including pharmaceutical, device, biotech, and durable medical equipment manufacturers; hospitals and other large institutional health care providers; research institutions; health information technology companies; pharmacies; skilled nursing facilities; physician practices and other service providers; insurance companies; diagnostic laboratories; wholesalers; trade groups; and private equity funds that invest in health care companies.

What types of cases/deals do you work on?

Beth: I work with clients on a wide range of regulatory and enforcement matters. These matters involve, for example, counseling clients on drug product launches and the complicated interplay of pricing, coding, coverage, and reimbursement issues. I also regularly advise clients on government program and price reporting obligations, as well as on compliance program best practices. My practice also includes responding to internal and government investigations relating to, for example, patient assistance programs. This work regularly involves meeting with government agencies, such as the Centers for Medicare and Medicaid Services, the Health Resources and Services Administration, and the Office of Inspector General, as well as engagement with congressional offices. In light of my passion for disability rights, I have focused my pro bono work on disability-related cases and projects.

Neil: I represent clients in high-stakes, bet-the-company litigation and white collar criminal and civil investigation and enforcement matters. Matters I’m handling now include representing a pharmaceutical manufacturer in civil litigation in federal court, assisting a medical technology company in an internal investigation, representing a national pharmacy chain in an investigation by the Department of Justice and state governments, and representing a physician association in class action antitrust litigation. I also maintain an active pro bono practice, through which I recently assisted a family with an adoption and litigated a lease dispute on behalf of a local nonprofit.

How did you choose this practice area?

Beth: I have always had an interest in health care issues. As an undergrad, I majored in health care policy, and while in law school, I knew I wanted to bring that interest into my legal career. When looking at firms, I was drawn to Sidley because of its incredibly strong and diverse health care practice that included policy and regulatory work, allowing me to dive into the coverage and pricing issues I have long had an interest in.

Neil: I interned in the Civil Frauds Section of the Department of Justice after my first year in law school. That section oversees many of the investigations which clients retain Sidley to defend. The complex and ambiguous issues that I saw during the internship led me to seek out opportunities to learn more about the health care industry and to advocate on behalf of parties litigating often-unclear legal requirements. In addition to the subject matter of the practice area, I was also drawn to the Health Care group’s diverse work: on any given day, associates may be drafting a dispositive motion in a fraud case, researching antitrust law, analyzing recent settlements to advise a client on litigation risk, or preparing a presentation to defend a client before the government in a closed-door meeting.

What is a typical day like and/or what are some common tasks you perform?

Beth: Every day is different, and that’s one aspect of the practice I love. As a regulatory lawyer, many of my matters are relatively discrete, which means that in a day, I can jump around on as many as 15 different matters. The work varies from researching—and even drafting—new legislation, drafting comment letters addressing new government rules, advising clients, fact gathering for investigations through witness interviews, or meeting with the government, to name just a few daily tasks. Through my six years at Sidley, I have handled a wide array of cases and matters resulting in a deep understanding of the health care industry. I think such broad health care experience is unique at a law firm.

Neil: Each day varies significantly based on the status of different matters. For example, sometimes I may spend a half or full day conducting interviews at a client site, appearing in court, or presenting to the government. Other days might be a mix of motion drafting, phone calls with clients, correspondence with experts, and legal research. In addition to those tasks, other common tasks include managing document productions, drafting factual summaries based on our investigation, and analyzing recent filings in our cases.

What training, classes, experience, or skills development would you recommend to someone who wishes to enter your practice area?

For students interested in regulatory work, taking administrative law can be beneficial. For those interested in litigation, civil procedure and evidence are the most helpful courses. To the extent offered, seminars in health care or food and drug law and antitrust can also be helpful.

What misconceptions exist about your practice area?

Lawyers in Sidley’s health care practice do not handle medical malpractice cases, which some people think of when they hear “health care law.” Instead, the group’s work focuses on the industry’s interactions with the government, including advocating for policy change, complying with regulatory requirements, and addressing allegations of illegal conduct for large corporate health care clients. While not malpractice-related, on the regulatory side, we also have experience with some patient-facing issues, such as advising on patient outreach and patient education, as well as coverage denials, which can be very interesting.

What is unique about this practice area at your firm?

Sidley is uniquely positioned among major health care practices to advise on the full range of issues facing companies in the industry. From compliance issues and regulatory issues that are deep in the weeds of agency guidance to investigations and active litigation, Sidley has expertise in all areas. As a junior associate, you typically get immediate experience on complicated regulatory issues, which position you to better advise clients on enforcement and litigation work. Sidley has more than 100 lawyers who have held senior positions within key regulatory agencies in the U.S. and around the globe.

What are some typical tasks that a junior lawyer would perform in this practice area?

Junior lawyers perform a wide variety of tasks. For example, on the litigation side, a junior lawyer may be the only associate working on a small investigation, in which case that associate will need to balance researching law, managing document production, assisting with witness interviews, and drafting memos and presentations. On a larger matter, the same associate may have a more narrow focus, but will still be responsible for developing a mastery of key facts and proactively identifying ways to put the client in the best position for a successful result. On the regulatory side, junior associates work directly with partners on client questions, which may range from how to implement a new rule, legal issues with a new business initiative, or questions on how to seek coverage for a new product. Junior associates get immediate client contact through calls and in-person meetings, as well as exposure to government agencies through government meetings.

What kinds of experience can summer associates gain in this practice area at your firm?

Attorneys in the health care practice often ask summer associates to sit in on calls with clients, the government, experts, and opposing counsel. Additionally, summer associates regularly assist with researching law and drafting analytical memos for clients and often have the opportunity to attend and present at client meetings.

Elizabeth Kolbe and Neil Nandi, Associates—Health Care

Elizabeth (“Beth”) Kolbe is an associate in Sidley’s Health Care group in Washington, DC. She was a summer associate at Sidley in 2011 and has been at Sidley for more than six years. Her practice involves representing clients from a range of stakeholders in the health care industry (e.g., pharmaceutical, device, and durable medical equipment manufacturers; insurers; provider groups; health care technology companies; and many others) and focuses on health care regulatory and compliance matters, including federal health care coverage, coding, and reimbursement issues; government price reporting; health care compliance; health information privacy; government and congressional investigations; and health care fraud and abuse. Beth’s work involves engagement with government agencies and lobbying in Congress. She is also active in Sidley‘s Summer, Diversity, and Women’s Committees, among others. Beth received her undergraduate degree from Harvard and her law degree from Stanford.

Neil Nandi is a litigator in Sidley’s Health Care group in Chicago. He has represented pharmaceutical and medical device manufacturers, medtech companies, pharmacies, and large health care providers in investigations, False Claims Act cases, and antitrust class actions, among other matters. His most memorable experiences include taking depositions and drafting motions and appellate briefs. He highly values his pro bono work, including representing a nonprofit in an arbitration and helping an asylee obtain her green card. Neil attended the University of Pennsylvania for college and Harvard for law school, after which he clerked for Judge James B. Loken of the U.S. Court of Appeals for the Eighth Circuit.

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