Zubin Khambatta
Partner
Overview
Zubin Khambatta is a healthcare attorney in Holland & Knight's Austin office. He represents hospital systems, academic medical centers, specialty and pediatric physician practices, clinical laboratories, behavioral health and telehealth providers, and digital health and technology companies in transactional, regulatory and reimbursement matters.
Mr. Khambatta regularly represents healthcare clients in mergers and acquisitions (M&A), joint ventures, strategic collaborations and venture and equity financings, including acquisitions by private equity-backed platforms, strategic acquisitions, institution-to-institution affiliation and collaboration agreements, and the acquisition, sale or restructuring of hospitals, physician practices, ambulatory surgery centers, ambulance providers and behavioral health practices. Clients often turn to him to provide strategic advice and counseling for such transactions and reimbursement arrangements, including with respect to joint venture arrangements, professional services agreements, provider network agreements, public-private partnerships (P3), academic medical center affiliations, the provision of hospital and medical services, data-sharing and electronic health records agreements, and agreements on behalf of or with group purchasing organizations. He also advises on corporate governance matters.
A primary focus of Mr. Khambatta's practice is counseling healthcare providers on reimbursement matters and issues involving the Medicaid and Medicare programs. In this vein, he regularly advises clients on reimbursement and government funding opportunities and challenges that arise under Medicaid and uninsured supplemental payment programs (e.g., state-directed programs, uncompensated care pools, Medicaid Disproportionate Share Hospital (DSH) payments, Upper Payment Limit (UPL) payments), Medicare and Medicaid reimbursement methodologies and policy matters for inpatient, outpatient, physician and other services, and various state Medicaid finance issues involving healthcare-related taxes and related funding mechanisms.
Mr. Khambatta is relied upon to guide clients on regulatory and compliance matters governing the delivery of healthcare, including the full panoply of federal and state healthcare fraud and abuse laws, licensure and accreditation requirements, the regulation of the practice of medicine, including the corporate practice of medicine and fee-splitting restrictions, Medicare Advantage compliance, Emergency Medical Treatment and Active Labor Act (EMTALA) requirements, and compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and other federal and state health privacy laws.
Additionally, Mr. Khambatta's practice encompasses counsel to startups and emerging companies that develop and market digital health services and medical devices. He regularly advises clients on healthcare technology and data-related matters, including requirements under HIPAA, the Health Information Technology for Economic and Clinical Health Act (HITECH), 42 C.F.R. Part 2, and other federal and state privacy laws.
For several years, Mr. Khambatta has represented healthcare organizations in litigation matters and regulatory enforcement actions before federal and state regulatory authorities. He strives to ensure his clients benefit from this experience and works with them to avoid regulatory pitfalls and mitigate compliance and liability risks, while also providing hands-on, efficacious counsel and representation if litigation becomes necessary or enforcement actions arise.
Prior to joining Holland & Knight, Mr. Khambatta was a partner in the Austin office of an international law firm.
Representative Experience
- Successfully represented a large, integrated academic medical center before Centers for Medicare & Medicaid Services (CMS) and federal auditors in appeal of denial of provider-based status for multimillion-dollar outpatient center; CMS retracted prior denial in full
- Successfully represented a leading children's hospital in litigation pursuing claims of underpayment by Medicaid managed care organization (MCO); settled case for 100 percent of claimed damages
- Represented a public hospital district in mediation involving breach of services agreement to provide care to more than 60,000 covered patients
- Represent public hospital districts in matters involving Section 1115 Uncompensated Care (UC) and Delivery System Reform Incentive Payment (DSRIP) programs, and hospital- and physician-directed payment programs
- Represent a public hospital district in administration of local provider tax
- Represented a health insurer in Federally Qualified Health Center (FQHC) reimbursement matters
- Represented a telehealth company in contracting with Medicare Advantage and Medicaid managed care plans
- Represent various providers in counseling regarding applications for Coronavirus Aid, Relief, and Economic Security (CARES) Act Provider Relief Fund disbursements and related regulatory and audit compliance and submissions
- Routinely represented several children's hospitals in their participation in UC Medicaid supplemental payment program of Texas' Section 1115 Medicaid demonstration waiver
- Served as lead counsel in securing $170 million in withheld Medicaid UC funding for stand-alone children's hospitals in Texas
- Routinely represented several children's hospitals in their participation in Medicaid Disproportionate Share Hospital (DSH) program
- Served as lead counsel in securing $72 million in Medicaid DSH funding for children's hospitals out of a total pool of $245 million that state was withholding to comply with federal court injunctions
- Represented children's hospitals in ongoing efforts to secure and implement Medicaid and Children's Health Insurance Program (CHIP) rate increase of $125 million
- Routinely represented several Texas hospitals with respect to participation in Texas' Delivery System Reform Incentive Payment (DSRIP) program under Texas' Section 1115 Medicaid demonstration waiver
- Routinely represented Texas hospitals with respect to participation in state's Uniform Hospital Rate Increase Program (UHRIP)
- Regularly represented a statewide ambulance association with respect to Medicaid reimbursement initiatives
- Represented various physician groups in development of statewide Medicaid physician supplemental payment programs for fee-for-service and managed care reimbursement
- Represented national hospital systems with participation in Medicaid supplemental payment programs in Texas, Nevada and South Carolina
- Advised a healthcare reimbursement company on appropriate compliance framework required by Medicare Advantage regulations
- Regularly advised hospital systems with respect to federal and state Medicaid managed care regulations
- Represented an academic medical center with respect to structuring of Medicaid supplemental reimbursement for physician services
- Transactional and regulatory attorney for formation of physician group of specialized oncology care research center
- Lead transactional and regulatory counsel for an integrated health system in long-term strategic collaboration to transform the delivery of specified specialty areas
- Lead transactional and regulatory counsel for an integrated health system in long-term professional services arrangement with an academic medical center
- Lead regulatory counsel in sale of an addiction treatment and behavioral health provider serving adolescent males
- Lead transactional and regulatory counsel in sale of a physician specialty group and ancillary suppliers of healthcare items and services
- Lead regulatory counsel in sale of a multistate ambulance provider
- Lead regulatory counsel in sale of a behavioral health provider
- Lead regulatory counsel in sale of a home health provider
- Lead transactional and regulatory counsel for negotiation of electronic health record (EHR) arrangement implemented for clinically integrated network of more than 60 physician practices
- Represent a leading children's hospital in multimillion-dollar purchase of medical equipment and related development arrangements
- Represent various digital health and medical device companies in development of professional services, distribution and customer agreements
- Represented a healthcare technology company in acquisitions of, and joint ventures with, ambulatory surgery centers
- Represented one of Texas' largest hospital districts in restructuring of agreements to provide safety net care
- Represent clinically integrated network of pediatric practices in group purchasing organization arrangements
- Lead regulatory counsel in Series A equity financing for a telehealth provider
- Represent telehealth and digital health companies in various sales transactions
- Represented a clinical laboratory in advising on telehealth relationships and marketing arrangements
- Represented a large academic medical center in drafting of a provider agreement with a university practice plan
- Regularly represent several children's hospitals in Medicaid managed care contracting matters
- Represented anesthesiology groups in cash and rollover equity transaction to a private equity-backed platform
- Represented a large anesthesiology group in a spinoff of one of its divisions
- Represented a board-certified behavior analyst (BCBA) practice in cash and rollover equity transaction to a private equity-backed platform
- Represented a physician-owned hospital in sales transaction to one of the nation's largest hospital systems
- Represented a physician group in equity sales of ambulatory surgical centers
- Represented an academic medical center in a joint venture arrangement with a physician specialty group
- Represented a hospital in contractual restructuring of affiliation with a medical school and medical school's physician practice plan
- Drafted a management agreement on behalf of a hospital system to manage a rural, safety net hospital
- Routinely represent providers with respect to completion of formation and governance documents related to qualification as Texas nonprofit health organization
- Drafted dozens of physician, medical director and administrative services agreements
- Drafted and provided advice regarding healthcare services agreements related to behavioral health, magnetic resonance imaging (MRI) services, diagnostic testing and services of ancillary providers
- Represent a large, integrated academic medical center in review of physician compensation structure for compliance with the Stark Law, federal Anti-Kickback Statute (AKS), and related fraud, waste and abuse laws
- Represent a large, integrated academic medical center in various regulatory matters involving Medicare and Medicaid reimbursement
- Lead counsel in development and implementation of a Fortune 500 technology company's first healthcare compliance program
- Represent one of state's largest hospital districts in regulatory setup and administration of provider tax that exceeds $35 million annually
- Regularly advise healthcare organizations about compliance with federal Medicaid regulations regarding impermissible provider-related donations
- Routinely represented a hospital owned by one of country's largest hospital organizations regarding matters related to coverage and reimbursement through Affordable Care Act (ACA) exchange policies
- Routinely represent a hospital district in regulatory matters related to provision of indigent care
- Counsel an academic medical center on application, certification, reporting and audit requirements for Coronavirus Aid, Relief, and Economic Security (CARES) Act Provider Relief Fund distributions
- Counsel a dental services organization on application, certification, reporting and audit requirements for CARES Act Provider Relief Fund distributions
- Represented an independent physician association with respect to False Claims Act (FCA) review of various reimbursement arrangements
- Regularly advised hospitals regarding requirements of state law provider tax rules and compliance of provider tax arrangements with federal regulations
- Regularly advised healthcare contractors about compliance with Medicare Advantage regulations governing delegated activities
- Regularly counseled physician groups and hospitals regarding compliance with federal and state anti-kickback laws, federal Civil Monetary Penalties Law (CMPL) and Texas Patient Solicitation Act
- Regularly counseled physicians' groups and hospitals regarding compliance with Physician Self-Referral (Stark) Law
- Drafted emergency department policies consistent with Emergency Medical Treatment and Labor Act (EMTALA)
- Regularly advised nonprofit hospital clients regarding compliance with state law charity care requirements
- Advised a multistate hospital system about Medicare secondary payer regulations when care is provided to accident victims
- Advised a national hospital system about liability risks arising from application of federal and state laws excluding providers from Medicare and Medicaid participation
- Advised a long-term acute care hospital on compliance with hospital-within-hospital regulations related to nurse staffing
- Regularly counseled and advised clients regarding potential FCA liability related to participation in Medicaid supplemental reimbursement programs
- Routinely counseled clients regarding Texas Medical Board (TMB) certification of nonprofit health organizations
- Advised a national hospital system about Form 990 reporting of charity care activities under federal laws governing tax exempt organizations
- Routinely advised providers on state law network adequacy rules required of health insurers
- Successfully represented a leading children's hospital in litigation pursuing claims of underpayment by Medicaid managed care organization (MCO); settled case for 100 percent of claimed damages
- Successfully represented a digital health company in dismissal of enforcement investigation brought by state board of optometry; board took no action
- Successfully represented a chain of fitness clubs in dismissal of enforcement investigation brought by state board of physical therapy; board took no action
- Represents a hospital district in ongoing investigation conducted by U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG)
- Represented a hospital in a lawsuit to enforce hospital liens against tortfeasor's insurance company
- Represented a revenue cycle management company in Minnesota attorney general investigation and related federal lawsuits alleging that company's interactions with patients and alleged failure to safeguard patient medical information violated Emergency Medical Treatment and Active Labor Act (EMTALA), Health Insurance Portability and Accountability Act (HIPAA), and state laws regarding health records, consumer fraud and debt collection
- Represented the country's largest private health insurance association in antitrust matters arising from allegations that association's trademarks licensing practices violate Sherman Act and related antitrust laws
- Represented a manufacturer of retail pharmacy equipment in commercial arbitration against a Fortune 100 pharmaceutical company
Credentials
- The University of Chicago Law School, J.D.
- University of Edinburgh, M.Sc., Social and Political Theory, with highest distinction
- University of Pennsylvania, B.A., Political Science and Intellectual History, magna cum laude
- Illinois
- Texas
- U.S. District Court for the Northern District of Illinois
- U.S. District Court for the Central District of Illinois
- U.S. Court of Appeals for the Seventh Circuit
- American Health Law Association (AHLA), Leadership Group – Physician Organizations Practice Group, 2023-2024
- American Bar Association, Health Law Section
- Austin Bar Association, Health Law Section
- Austin Speech Labs, Board Member, 2018-Present
- Phi Beta Kappa
- Rising Star, Illinois Super Lawyers magazine, General Litigation, 2010-2014
- Pro Bono Service Award, 2009