Ben Wilson provides transactional, strategic, and regulatory advice to clients throughout the health care industry. He focuses on transactions involving complex financing, reimbursement, and regulatory considerations, including health care and academic medical center affiliations, mergers and acquisitions, joint ventures and other business arrangements. He has extensive experience representing health care, higher education, and other nonprofit institutions in financing transactions, and also serves as underwriters' counsel, bond counsel, and disclosure counsel in connection with tax-exempt and taxable financings. Ben assists clients in navigating complex government and commercial reimbursement and payment programs, counsels clients regarding compliance with Medicare and Medicaid requirements, and represents clients in payment disputes and appeals. He advises boards of directors in a variety of governance and general corporate matters. He has served as outside general counsel to a health system and as in-house counsel at a leading children’s hospital. Ben regularly counsels clients in a broad array of health care regulatory matters, ranging from accreditation and licensing matters to patient care and ethics concerns.
Mergers, Acquisitions, and Affiliations
- Represented health systems in acquiring or affiliating with other health systems or providers.
- Advised health systems and universities, both public and private, in restating academic affiliations and restructuring faculty practices.
- Represented multiple national senior living enterprises in the acquisition of communities.
- Represented a national health insurance and delivery system in the sale of a minority equity investment to a private equity investor.
- Advised several human service organizations in acquisitions of businesses and properties in bankruptcy.
- Represented a nonprofit college in its acquisition of and merger with another college.
- Counseled health care providers in structuring and implementing novel joint ventures and contractual affiliations, requiring resolution of complex licensing and reimbursement issues.
- Represented a private equity sponsor in the sale of a nationwide pharmacy services company.
Value-Based Care and Managed Care Organizations
- Counseled health care providers, health plans, and health care ventures in establishing value-based payment structures and managing associated licensing and regulatory requirements.
- Represented a health center in establishing a clinically-integrated behavioral health network for participating in Medicaid value-based care models.
- Advised a consortium of behavioral health and human service organizations in establishing a clinically integrated network in anticipation of Medicaid program restructuring.
- Represented a leading academic medical center in its negotiations and disputes with payors.
- Advised a health insurer with respect to the sale of a Medicare Advantage plan.
- Represented a health insurer in a novel financing and data sharing transaction with a national research foundation.
- Represented health systems, universities, and other institutions as borrower’s counsel, handling substantially all financing matters.
- Structured and restructured obligated groups and master indentures for multiple health systems.
- Represented health systems and other nonprofit organizations in or near default in negotiating consents and workouts with lenders and bond insurers.
- Served as underwriters’ counsel for taxable and tax-exempt public offerings, and as bond counsel for public and private issuances.
Medicare and Medicaid
- Represented health care providers in appeals and administrative hearings relating to alleged Medicare and Medicaid overpayments.
- Counseled several of the nation’s leading children’s hospitals on the provider-based rules, rules relating to co-location of hospital facilities, and rules relating to sharing of hospital space.
- Advised an academic medical center with respect to compliance with federal and state rules relating to intergovernmental transfers and Medicaid supplemental funding.
- Regularly advised clinical laboratories with respect to licensing, certification, reimbursement, and FDA compliance.
- Advised a leading multi-state health system in evaluating and redesigning its network of laboratories for hospital, physician group, and outreach testing.
- Represented a national independent laboratory in multiple, high-stakes Medicare and Medicaid appeals, including proceedings before administrative law judges and related litigation.
- Counseled a leading research institute in establishing a clinical laboratory.
- Member of Update Committee, NABL Form Indenture and Commentary (forthcoming in 2019)
- Co-author, “INSIGHT: Kickbacks or Common Sense Business? Hurdles for Value-Based Care,” Bloomberg Law’s Health Law and Business (December 10, 2018)
- Co-author, “Fundamentals of Managed Care,” MCLE, Massachusetts Health and Hospital Law Manual (November 10, 2017)
- Co-author, “Massachusetts Health Care Reform: The Next Stage,” Bloomberg BNA’s Health Care Policy Report (January 28, 2013)
- Co-author, "Justice for All: New Life for the Massachusetts Equal Rights Amendment," Massachusetts Law Journal (August 14, 2011)
- Presenter, Hot Topics in Value-Based Care, MCLE 20th Annual Hospital & Health Law Conference 2019 (May 23, 2019)
- Presenter, New Federal All-Payor Anti-Kickback Provisions: What Providers Should Know and Should Be Thinking About Now (December 18, 2018)
- Panelist, Debt, the Capital Markets and Decision-Making: How the Legal and Financial Environments Influence Capital Finance Decisions, HFMA Capital Finance Seminar, Debt Management and Risk Management (November 1, 2018)
- Presenter, Value-Based Health Care for AMCs and Health Systems Part I: Network Development (April 17, 2018)
- Moderator, Payment Reform: What is Value, HFMA Seminar, Value Propositions: M&A, Payment Reform and IT Investment (November 15, 2017)
- Presenter, Managed Care Organizations, MCLE Health & Hospital Law BasicsPlus, (November 14, 2017)
- Presenter, Remote Patient Monitoring: Apps, Wearables, and the Regulatory Landscape, Massachusetts Bar Associations 26th Annual Health Law Symposium (May 20, 2016)