Adam Carter RoseStockholderAdam Carter Rose is Chair of the Health Care Practice Area and Co-Chair of the Nonprofit Organizations Practice Area, as well as a Stockholder, at Reid and Riege. Adam is AV® Preeminent™ Martindale-Hubbell Peer Review Rated (the highest possible rating in both legal ability and ethical standards). For over a decade, Adam has worked with physician practices and for profit and nonprofit health care and human services organizations across Connecticut on corporate, employment, regulatory, and transactional matters.
Adam serves as outside general counsel and special counsel to a wide array of health and human service organizations (community hospitals, behavioral health providers, FQHCs, community living arrangements, hospice and home health providers, family services agencies, etc.) and medical practices ranging in size from “supergroups” to solo practices, covering a number of specialties (radiology, pathology, gastroenterology, anesthesiology, orthopedics, general surgery, oral surgery, ophthalmology, primary care, OB/GYN, podiatry, dentistry, etc.), in addition to servicing the employment and other needs of individual health care professionals.
Some of Adam’s focuses include:
- Federal and state regulatory compliance, counseling, and defense (including Stark law, fraud and abuse, false claims, and tax exempt matters);
- Physician practice governance and employment (buy-sell arrangements, bylaws/operating agreements, employment agreements, and noncompetition counseling);
- Mergers, acquisitions, and affiliations;
- Complex professional service arrangements and joint ventures;
- State agency service and grant contracts (DMHAS, DDS, DSS, and DCF);
- Privacy counseling (HIPAA, Part 2, Connecticut statutory privileges);
- Managed care contract negotiations and disputes;
- Medicare/Medicaid/commercial payor coverage and reimbursement compliance and audit defense;
- Physician and facility licensure and Certificate of Need matters;
- Health care related white collar defense (OIG, DEA, and DCP Drug Control investigations); and
- All manner of health care related vendor contracting (including sophisticated electronic health record and outside billing arrangements, equipment purchasing, consulting and revenue cycle support contracts, etc.).
- Connecticut Health Lawyers Association
- Connecticut Health Council
- American Health Lawyers Association
- Connecticut Healthcare Financial Management Association, Member
- Connecticut Bar Association, Health Law Section
- American Bar Association, Health Law Section
- American College of Radiology's Attorney Referral List, State of Connecticut
- AV® Preeminent™ Martindale-Hubbell Peer Review Rated
- Listed in New England Super Lawyers Magazine® as a Connecticut Rising Star® for Health Care (2012, 2014-2016)
Representative MattersRepresents one of the largest pathology practices in Connecticut with respect to corporate, regulatory, and transactional matters, including negotiations with hospitals, independent clinical laboratories, and physician-owned laboratories.
Represents one of the largest radiology practices in Connecticut with respect to corporate, regulatory, and transactional matters, including hospital contracting, physician employment, stockholder retirements, reimbursement disputes, and evaluating market opportunities.
Represents several large behavioral health providers and other nonprofit social service and health care providers with respect to corporate, regulatory, and transactional matters, including assisting one such client in reorganizing as a Federally Qualified Health Center-Look-Alike and successfully obtaining federal designation from the Health Resources and Services Administration (HRSA).
Frequently represents hospitals, physician practices, and behavioral health providers in structuring corporate affiliations and acquisitions.
Frequently represents individual physicians with respect to employment, licensure, and billing/coding matters, as well as evaluation and facilitation of stockholder status.
Frequently represents providers with respect to payor audits and challenges to claim denials, including having assisted two separate clients in fully eliminating alleged overpayments in excess of $100,000 to the Department of Social Services (DSS).
Frequently represents community hospitals, physician practices, and behavioral health providers with respect to patient privacy matters including drafting policies and procedures, advice regarding breach assessment, and handling subpoenas and other requests for patient information.
Other Notable RepresentationsAssisted a Connecticut medical marijuana producer in being awarded one out of four licenses to operate from the Department of Consumer Protection.
Assisted a hospital/physician practice imaging joint venture in the conversion of an IDTF to a provider-based entity.
Represented a trade association of family service agencies with respect to structuring a fiscal intermediary relationship with the Department of Social Services for the purpose of obtaining and administering approximately $18 million of federal assistance funds (TANF ECF).
Overturned a negative commercial insurer medical necessity determination on behalf of a teenage patient, providing access to a critical treatment that was historically considered experimental.