 |
Published July 24, 2026 Author: Patrick Formato. Executive Partner and Director of the Healthcare Law Practice at Abrams Fensterman, LLP. 516-328-2300 |
Hospital Representation for Health Systems and Academic Medical Centers
Abrams Fensterman, LLP serves as outside general counsel and special counsel to hospitals, health systems, academic medical centers, and multiprovider networks across New York. Hospitals operate as complex institutions under constant regulatory oversight, and their legal needs rarely fit inside a single practice area. This page addresses the institution-level matters that define hospital representation, from medical staff governance to facility licensure, and connects each enterprise issue to the focused Abrams Fensterman team that handles it.
Our attorneys work with institutional clients on an ongoing basis rather than one matter at a time, giving hospitals a single legal relationship that spans regulatory, operational, and patient-care questions as they arise.
What Does a Hospital Representation Attorney Do?
A hospital representation attorney serves as outside general or special counsel to hospitals, health systems, and academic medical centers, handling medical staff governance, credentialing and peer review, Certificate of Need and Article 28 licensure, accreditation, and patient care matters. Abrams Fensterman represents New York health care institutions across these interconnected regulatory and operational matters.
Scope of Our Hospital Representation
Abrams Fensterman works with hospitals and multiprovider networks as outside general counsel or special counsel, addressing legal needs on an ongoing basis, including:
- Federal and state regulatory matters, including licensing and Certificate of Need applications
- Stark, and fraud and abuse counseling
- Corporate compliance program development and implementation including audits and self-disclosures
- Audits, surveys and government investigations
- Managed care contracting including fee-for-service and risk agreements with managed care providers
- Medical staff issues including bylaws, internal due process and discipline hearings, litigation, and Office of Professional Medical Conduct, Office of Professional Discipline and National Practitioner Data Bank reporting
- Residency training accreditation matters including strategic planning, program information form reviews, surveys, responding to proposed adverse accreditation decisions, and appeals
- Reimbursement and payment issues
- Commercial litigation, including contractual disputes
- Medical malpractice defense
- HIPAA compliance
- IPA formation and representation
- Physician and other provider agreements
- Research compliance advice
- Joint Commission issues
- Discharge planning and payment recovery counseling to resolve complex patient discharge, treatment and payment issues
- Physician practice issues including restructuring physician practices due to acquisition or divestiture
- Guardianships under Mental Hygiene Law Article 81 and Surrogate’s Court Procedure Act Article 17A
- Mental hygiene hearings and counseling including retention, Kendra’s Law/assisted outpatient treatment, and medication and ECT over objection hearings
- Patient treatment issues including DNR, Health Care Proxy and withholding and withdrawal of life-sustaining treatment
- Vendor agreements
- Electronic medical records
- Corporate tax matters
- Capital project development and financing
- Workers’ compensation and no-fault payment recovery
Medical Staff Governance, Credentialing, and Peer Review
The medical staff is the legal and operational core of a hospital, and disputes there carry direct consequences for both the institution and the individual physician. Abrams Fensterman advises hospitals on medical staff bylaws, credentialing and privileging decisions, and the internal due process that governs corrective action. We guide clients through peer review proceedings and internal disciplinary hearings, structuring the process to withstand later challenges while protecting the institution’s quality obligations.
When an adverse action requires reporting, we advise on obligations to the National Practitioner Data Bank and coordinate any related reports to the New York State Office of Professional Medical Conduct and the New York State Education Department Office of Professional Discipline. Because a single credentialing dispute can escalate into litigation, our medical staff work is built to hold up under scrutiny from the outset.
Certificate of Need and Article 28 Licensure
Hospitals in New York are licensed under Article 28 of the Public Health Law and cannot construct, expand, or substantially change services without state approval through the Certificate of Need process. Abrams Fensterman prepares and shepherds Certificate of Need applications and establishment approvals before the Public Health and Health Planning Council, and advises institutions on the licensure and governance requirements that Article 28 imposes on operators. We counsel hospitals on capital project development and the regulatory approvals that major service changes require.
Accreditation and Residency Training Compliance
Accreditation status affects a hospital’s reputation, reimbursement, and ability to train physicians. Our attorneys assist institutions with Joint Commission matters and with graduate medical education accreditation, including strategic planning, program information form reviews, and survey preparation. When a hospital faces a proposed adverse accreditation decision, we respond to findings and pursue appeals to protect the program and the institution.
Hospital Patient Care and Mental Hygiene Matters
Hospitals routinely confront legal questions at the point of patient care. Abrams Fensterman advises institutions on retention and involuntary treatment proceedings under Article 9 of the Mental Hygiene Law, on assisted outpatient treatment under Kendra’s Law at Mental Hygiene Law Section 9.60, and on medication and electroconvulsive therapy over objection hearings. We also counsel hospitals on Do Not Resuscitate orders, health care proxies, and the withholding or withdrawal of life-sustaining treatment, and on discharge planning where treatment and payment issues intersect. Where a matter reaches the substantive mental health practice or a guardianship petition, we coordinate with the firm’s Mental Health Law and Guardianship Law teams, who handle Article 81 and Article 17-A proceedings.
Institutional Operations and Governance
Beyond clinical and regulatory questions, hospitals need counsel on the agreements and structures that keep the institution running. We advise on vendor agreements, electronic medical records arrangements, board and corporate governance, and the corporate tax and financing questions that accompany capital projects. Our goal is to give institutional leadership a legal foundation that supports growth while containing risk.
Coordinated Health Law Support for Hospitals
Hospital matters frequently branch into specialized areas, and each connects to a focused Abrams Fensterman practice. Audits and enforcement route to our Government Audits and Investigations, Insurance and OMIG Audit Defense, and Health Care Fraud and Regulatory Enforcement teams. Compliance program development is handled by our Compliance Programs group. Revenue and payor issues route to Managed Care and Health Care Collections and Reimbursement Recovery. Liability and disputes are led by our Medical Malpractice Defense and Health Care Litigation teams, and institutional transactions by Health Care Mergers and Acquisitions. All of it sits under the firm’s broader Health Law practice.
Contact Our Law Firm
For further information about our hospital representation services, contact Abrams Fensterman on Long Island at 516-328-2300, in Brooklyn at 718-215-5300, in White Plains at 914-607-7010, in Rochester at 585-218-9999, or in Albany at 518-535-9477 to schedule an initial consultation.
Frequently Asked Questions
What is hospital representation?
It is the ongoing legal relationship in which a firm acts as outside general or special counsel to a hospital or health system, covering the institution’s medical staff, licensure, accreditation, operational, and patient-care matters.
What is the difference between hospital representation and medical malpractice defense?
Hospital representation covers the institution’s governance, licensure, and regulatory needs, while malpractice defense addresses specific liability claims. Abrams Fensterman handles both through coordinated teams.
Does a hospital need a Certificate of Need to expand?
Under Article 28 of the Public Health Law, hospitals generally need state approval through the Certificate of Need process to construct, expand, or substantially change services. The specific review level depends on the project.
What happens in a hospital peer review or credentialing dispute?
The hospital follows the internal due process set out in its medical staff bylaws, which may include a fair hearing. Adverse actions can trigger reporting obligations to the National Practitioner Data Bank.
