Our people

Karl is a member of the Life Sciences Health Industry Group, practicing in the area of health care regulatory law.  Karl heads the Health Care Law practice in the Philadelphia office.  Karl's practice is focused on providing business and regulatory advice to diverse clients in the health care industry, with particular emphasis on hospitals, health systems and academic medical centers.  His clients include proprietary, religiously affiliated, and nonprofit organizations operating general acute care hospitals and specialty hospitals (long-term acute care, inpatient rehabilitation, psychiatric and children’s hospitals).  He has substantial experience in structuring, negotiating and documenting a variety of complex business transactions, including mergers and acquisitions, financings, securities offerings, joint ventures, management agreements, and contractual relationships, among providers and with third-party payors.

Karl has particular experience assisting hospitals on arrangements with physicians, such as joint ventures, physician recruitment, practice acquisitions, employment arrangements, and exclusive provider agreements and is a recognized authority on compliance with federal and state laws governing referrals among health care providers, such as the "Anti-Kickback Law" and "Stark II."  He has also advised clients in the health care industry on business and nonprofit corporate law issues and regulatory issues, such as physician and facility licensing, the corporate practice of medicine, health information privacy, medical staff credentialing, professional liability insurance, patient care and informed consent.

Representative Matters

• Karl served as lead health care regulatory counsel in connection with a $2.6 billion transaction in which a national public company operating long term acute care hospitals, inpatient rehabilitation facilities and outpatient therapy clinics was acquired by a private investment group, including handling all regulatory disclosure matters in SEC filings related to a $660 million note offering (including LTCH and HIH qualification and reimbursement) and all federal and state regulatory approvals arising from the change of control.
• As lead transactional counsel, Karl represented a New Jersey nonprofit community hospital in a complex series of transactions under which the hospital purchased the facility of a competing hospital, relocated its operations to the new facility, and sold its preexisting property in a condemnation action to a state agency for development as public school facilities.  Among other things, Karl interacted with various state officials, including representatives of the Governor’s office and the Attorney General’s office, to address potential impediments to the transactions, including issues under the Community Health Care Assets Protection Act (“CHAPA”). 
• For one of the country’s largest general acute care hospital chains, Karl served as lead outside counsel in addressing major legal and political challenges arising from the company’s announcement that it would close one of its facilities.  The closure received significant attention in the press and with federal, state and local public officials, and Karl’s role included assessing the application of the state charitable trust doctrine; advocacy in meetings with high ranking state and city officials, including the Governor and representatives of the Attorney General, the Secretary of Health and the Mayor; and negotiating a favorable settlement with the city to resolve claims based on the facility’s ownership structure developed by prior counsel.
• For a leading religiously-affiliated nonprofit hospital system in Pittsburgh, Karl developed and implemented a strategy to reconfigure one of the system’s hospitals from a general acute care hospital to an off-campus inpatient psychiatric unit of another system hosptial, including structuring under Medicare inpatient unit and provider-based rules and negotiations with Pennsylvania Departments of Health and Public Welfare concerning licensure status and Medical Assistance payment issues.
• Karl represented one of the country’s foremost academic medical centers in its strategy to become a regional integrated delivery system by acquiring primary care medical practices.  Early in the development of the strategy, Karl’s legal assessment led to the development of a corporate ownership structure that was subsequently confirmed by government regulations, and thereafter, over a span of three years, Karl personally handled or oversaw over 50 physician practice acquisition transactions involving some 300 physicians.

Publications

• “New Stark Restrictions Go Into Effect October 1st,” published in August 2009 issue of Hospital News - Atlanta, Chicago and Western Pennsylvania editions
• Quoted, "AHLA Stark Reform Proposals Welcome, Have Little Chance of Success, Attorneys Say," published in the August 20, 2009 issue of BNA's Health Law Reporter
• “Health Information Privacy and Incentives, Medicaid Funding, and Other Health Care Provisions in the American Recovery and Reinvestment Act,” Reed Smith’s Life Sciences Legal Update Blog, March 4, 2009
• “Hospital Agrees to Pay $700,000 To Texas AG For Allegedly Orchestrating an Insurer Boycott of Competitor,” Reed Smith’s Life Sciences Legal Update Blog, January 28, 2009
• "Health Care Reform During the Obama Presidency: The Impact on Hospitals,” published in the August 20, 2009 issue of BNA's Health Care Policy Report, Vol. 16, No. 47, December 8, 2008
• “Significant Stark Law Changes Adopted in the 2009 IPPS Final Rule,” Reed Smith’s Life Sciences Legal Update Blog, August 25, 2008
• “Pennsylvania Proposes Regulations for a New Provider Type: Assisted Living Facilities,” Reed Smith’s Life Sciences Legal Update Blog, August 15, 2008
• “Proposed Stark Law Changes in CMS's 2009 IPPS Proposed Rule, Reed Smith’s Life Sciences Legal Update Blog, May 30, 2008
• "Recent Developments Regarding Hospital-Physician 'Gainsharing'," Reed Smith Health Care Client Memorandum, March 17, 2005
• "CMS Stark II (Phase II) Final Rule," Reed Smith Health Care Client Memorandum, April 27, 2004
• "The Top 10 Best and Worst of the Stark II, Phase II Regulations," published in the April 22, 2004 issue of BNA's Health Law Reporter
• "HHS Agencies Issue Industry Guidance on Hospital Discounts," Reed Smith Health Care Client Memorandum, April 6, 2004
• A contributing Editor of Physician’s News Digest, Delaware Valley Edition

Speeches / Presentations

• He has written and spoken on numerous topics related principally to business, reimbursement and regulatory issues of concern to health care providers

Experience

Legal Education

Graduate Education

Undergraduate Education

Professional Admissions / Qualifications

• Pennsylvania
• New Jersey

Professional Affiliations

• American Health Lawyers Association - Member, Healthcare Financial Management Association, Healthcare Compliance Association and other health industry professional associations
• Pennsylvania Society of Healthcare Attorneys - Board of Directors
• Selected as one of the top ten "Outstanding Healthcare Transaction Lawyers" in the United States in 2009 by Nightingale’s Healthcare News
• Selected for listing among "Best Lawyers: Healthcare" by Corporate Counsel magazine
• Listed by Law & Politics magazine as a "Pennsylvania Super Lawyer" in healthcare for 2004, 2005, 2006, 2007, 2008 and 2009
• Selected by peers for inclusion in The Best Lawyers in America in “Health Care Law”
• Awarded the highest "AV®" rating by the Martindale-Hubbell Law Directory
• Appointed to the Pennsylvania Department of Health QA ‘97 Work Group developing regulations for licensure of MRI and PET services in Pennsylvania in the wake of the sunset of the state’s CON program