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The increasing prevalence of renal disease in the United States has created a heightened need for dialysis centers throughout the country.  Waller has a wide variety of  experience in serving dialysis providers. Dialysis providers value our institutional depth and industry knowledge when it comes to the complexities of structuring joint ventures and syndications with physician groups and hospital systems.  We also provide counsel to dialysis providers in senior, subordinated, mezzanine, first lien and second lien commercial finance transactions involving banks, commercial finance companies, private equity funds and venture capital firms.

Our attorneys experienced specifically with the dialysis industry provide counsel on day-to-day operational issues, such as licensing, credentialing physicians, drafting medical director agreements and restrictive covenants, and Certificate of Need issues.  We assist dialysis clinics with recovering payments from Medicare, Medicaid and commercial third party payors and provide payor services covering a broad range of reimbursement challenges facing dialysis providers, including:

  • Medicare enrollment services, including the preparation and filing of enrollment forms (855A, 855B, 855R and others) for new facilities
  • Medicare revalidation
  • Contracting with third party payors
  • Advice and strategies for navigating out-of-network issues for commercial payors
  • Advice, negotiation and conflict resolution of payor disputes
  • Billing advice (excluding coding)
  • Internal investigations
  • Facility licensing
  • Assistance in resolving disputes related to survey certification, plans of correction and statements of deficiencies
  • Stark and anti-kickback compliance

In addition to representing dialysis providers in transactional and operational matters, Waller provides assistance in facility leasing, and we are experienced with the unique real estate issues associated with the operation of dialysis centers.  We also have defended dialysis providers in a wide range of labor and employment matters, including wage and hour complaints, and discrimination charges.

Vascular Access Centers

Vascular access centers (VACs) are a common ancillary service offered by a variety of physicians, mostly nephrologists.  Establishing VACs typically involves compliance with corporate laws, in-office surgery regulations and applicable self-referral laws.  Our attorneys are experienced in establishing and selling VACs and working through the complex regulatory environment.

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