Health Care Reform Keeps San Antonio Law Firms Busy


Law firms are lately experiencing a boom in business centered around their health care and employee benefits practices as a “perfect storm” of regulatory changes stirs up new demands for legal counsel.

 – Reporter- San Antonio Business Journal

Health care reform legislation such as the Patient Protection and Affordable Care Act (ACA), also known as Obamacare, is driving a lot of businesses to seek legal help in dealing with the flood of changes impacting all areas of life, says Josh Sutin, head of the Benefits and Tax Department for Cox Smith Matthews Incorporated in San Antonio. At the same time, new security requirements designed to protect patient data and information as part of the Health Insurance Portability and Accountability Act (HIPAA) are putting even more burdens on doctors and medical professionals. Finally, the Supreme Court’s ruling last year that overturned the federal Defense of Marriage Act (DOMA) means employers are going to have to be prepared for whatever impact that could have on their benefits and pension programs.

“We are seeing a perfect storm of changes impacting employee benefit plans across the country,” Sutin says. “It has led to a huge increase in that area of our practice.”

Cox Smith ranked No. 1 on the San Antonio Business Journal’s list of Largest San Antonio Law Firms, with 81 lawyers in San Antonio.

“Anyone who is an employer in San Antonio needs to be looking at these things,” Sutin says.

Even relatively small changes in the law can pose risks for companies if they are not being mindful of the regulations, Sutin says.

Cox Smith already has grown its employee benefits practice to keep pace with this increased demand and will continue to grow as needed in the coming year, Sutin says.

“I think the growth potential for us is tremendous,” Sutin says of the benefits practice. “While we still try to be efficient and run mean and lean to keep down costs, I think we are going to be in a growth mode for the next few years.”

Charlie Deacon, a partner at Norton Rose Fulbright in San Antonio, says they are seeing a lot more business in compliance areas, especially from health care providers.

“You have to be very sensitive to the changes in billing practices,” Deacon says. “The government has been very aggressive in going after providers who have been billing for more than they should.”

There has been an increasing risk to providers who are being asked to put in all these new safeguards and security measures while also being extra diligent in their billing practices, Deacon says.

“And they are being asked to do all this extra work for less money,” Deacon adds, “because the government is trying to reign in health care spending.”

That is one reason why Norton Rose attorney Deacon says he expects to see more consolidations in the health care industry in the coming year.

“(Health care providers) believe they can achieve an economy of scale with a larger organization and provide the same services at a lower cost,” he says. “As a result, we should see more transactional work as well as increases in our regulatory compliance areas.”

Norton Rose Fulbright ranked No. 3 on the San Antonio Business Journal’s list with 56 lawyers locally.

The government spends a lot of money on health care services, so it is no surprise that it is one of the first places they will look to reduce spending, Deacon says.

“The government has determined that it can make money by cracking down on fraud and abuse,” Deacon says. “So they have been staffing up and hiring in these areas to go after that money.”

But Deacon adds that San Antonio is blessed in that it has not been hit by too many cases of fraud and has largely avoided the problems plauging some areas of the country such as southern Florida.

“What I have found is that most clients don’t want trouble,” Deacon says. “They want to do the right thing and avoid making the kinds of mistakes that could get them into trouble.”

– Mike W. Thomas covers technology/telecom, military, finance, regulatory issues as well as nonprofits/education