Physician’s Practices

Running a medical practice means running a business, managing employees, navigating an increasingly complex regulatory environment, and planning for the future, all while keeping the focus where it belongs: on patient care.

The legal issues physicians face are wide-ranging and rarely fit neatly into a single area of law. Structuring a new practice, bringing on a partner, negotiating a hospital employment agreement, responding to a licensing board investigation, planning a sale or succession, managing a billing dispute with a federal payer, protecting the practice from a departing physician who takes patients with them — each of these requires a different kind of legal expertise.

Ward and Smith’s Physician’s Practices group draws on attorneys across the firm to give solo practitioners, group practices, and specialty practices access to the full range of legal resources they need, coordinated by attorneys who know the health care industry and understand how physician practices actually operate.

Who We Represent

We represent solo practitioners, single-specialty and multispecialty group practices, ambulatory surgery centers, diagnostic imaging centers, and other physician-owned or physician-led entities across North Carolina. Our clients include primary care and family medicine practices, surgical and procedural specialists, anesthesia practices, radiology and imaging groups, behavioral health practices, and independent physicians navigating employment transitions or disputes.

Services

Practice Formation and Governance

• Formation of professional corporations, professional limited liability companies, and other practice entities under the North Carolina Professional Corporation Act and Limited Liability Company Act
• Drafting and negotiating shareholder agreements, operating agreements, and buy-sell provisions
• Structuring ownership arrangements among physicians, including buy-in schedules and equity allocation
• Drafting partnership and co-ownership agreements for shared facilities and equipment
• Practice governance policies and procedures

Physician Employment and Compensation

• Drafting and negotiating physician employment agreements with hospitals, health systems, and group practices
• Review and negotiation of independent contractor arrangements and consulting agreements
• Compensation plan structuring for productivity-based, value-based, and hybrid models
• Non-compete and non-solicitation agreements: drafting, negotiation, and enforcement or defense under North Carolina law
• Separation and severance agreements

Transactions: Acquisitions, Sales, and Affiliations

• Sale of practice assets to hospitals, health systems, private equity platforms, and other group practices
• Acquisition of other practices and practice assets
• Mergers and affiliations among physician groups
• Ambulatory surgery center transactions and joint ventures with hospitals
• Exclusive professional services arrangements with hospitals and surgery centers
• Certificate of Need matters, including applications and “no review” letter requests to the North Carolina Healthcare Planning and Certificate of Need Section

Regulatory Compliance and Fraud and Abuse

• Stark Law (Ethics in Patient Referrals Act) compliance review and structuring
• Anti-Kickback Statute compliance counseling
• HIPAA privacy and security compliance, policies, and breach response
• Billing, coding, and documentation compliance
• Medicare and Medicaid reimbursement issues, including overpayment appeals before the Office of Medicare Hearings and Appeals
• False Claims Act investigation defense
• EMTALA compliance

Licensing Board Defense and Credentialing

• Defense of investigations and disciplinary proceedings before the North Carolina Medical Board
• Hospital credentialing disputes, peer review proceedings, and medical staff bylaw issues
• DEA registration and show cause proceedings
• Medicare exclusion defense and National Practitioner Data Bank reporting disputes
• HMO and health insurance credentialing and de-selection matters

Employment, HR, and Practice Management

• Employee handbooks, personnel policies, and HR compliance specific to medical practices
• Wage and hour compliance under the Fair Labor Standards Act
• EEOC charges and employment discrimination defense
• OSHA compliance for clinical settings
• Drafting and enforcement of staff non-disclosure and non-solicitation agreements

Real Estate and Facilities

• Lease negotiation and review for medical office space and clinical facilities
• Acquisition and sale of practice-owned real property
• Build-out and construction agreements for new or renovated clinical space
• Shared facility and equipment agreements

Business Succession and Exit Planning

• Succession planning for retiring physicians, including structured buy-outs and ownership transition timelines
• Estate planning considerations for practice ownership interests
• Key person insurance planning
• Sale or wind-down planning for practices approaching transition

The Full-Service Advantage

Medical practices encounter legal issues that span many disciplines simultaneously. A practice negotiating a hospital employment arrangement may also need tax counsel on compensation structure, real estate counsel on what happens to the building, and employment counsel on the non-compete terms. A practice defending a False Claims Act investigation may need white-collar defense counsel working alongside health care regulatory counsel. Ward and Smith’s team approach means those resources are coordinated within a single firm, without the delays and cost of assembling separate specialists.

Reach out to one of our Physicians Practice attorneys for more information regarding how we may be of assistance.