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McDermott Will & Emery

The following is an excerpt from Practice Perspectives: Vault's Guide to Legal Practice Areas.

Gregory Fosheim (he/him) provides counsel on a wide array of corporate, transactional, and regulatory compliance matters across the healthcare and life sciences industry. Drawing on his extensive laboratory and public health background and insight, he regularly advises on the regulatory oversight and reimbursement of clinical and diagnostic laboratory services, anatomic pathology testing, clinical research, and assisted reproductive technology and represents hospitals, health systems, and physician practice management companies in all aspects of transactional and operational matters, particularly those with regulatory, licensing, accreditation, and policy considerations.

Greg uses his public health background to write, speak, and advise on quality, access, and equity in the provision of healthcare services and serves as co-chair of McDermott’s LGBTQ+ Affinity Group.

Sumaya M. Noush (she/her) counsels multistate hospitals and health systems, specialty hospitals, academic medical centers, and other healthcare organizations on strategic and operational matters, including mergers, asset and membership/stock transactions, joint ventures, hospital and physician affiliations, disaffiliations, dissolutions, divestitures, management of ownership transitions, entity structure formation and governance, medical staff bylaws, credentialing, peer review, and privileging as well as survey, certification, and accreditation matters.

Sumaya closely partners alongside clients as they explore strategies for the future health of their communities, their missions, and their business goals, advising them through the challenges of daily operations and recent regulatory developments.

Sumaya is committed to improving the diversity of the profession as an Associate Board Director to the Chicago Committee on Minorities in Large Law Firms and an alumna of the Leadership Council on Legal Diversity institution.

Describe your practice area and what it entails.

Greg: I consider myself a full-service healthcare operationalist, meaning I advise clients across the industry on how to perform in a complex regulatory world. This may include advising on transactions, providing billing and coding guidance, counseling on licensing and enrollment requirements, and addressing myriad compliance and business concerns. My practice also has deep focus on the clinical and diagnostic laboratory industry, delivery of proton therapy, and advising on health equity and non-discrimination. I also present and write about these matters to lawyers and business owners alike.   

Sumaya: My focused representation of hospitals, health systems, academic medical centers, and other healthcare providers in complex corporate transactions, combined with my deep knowledge of the healthcare regulatory environment, allows me to provide clients with comprehensive and practical advice regarding their operations, corporate compliance, governance, and business strategies. In addition to my client advisement, I speak and write on emerging regulatory and corporate matters.  

What types of clients do you represent?

Greg: My practice engages with healthcare organizations across the industry and companies that interact with the delivery of healthcare in some way. This includes traditional hospitals and healthcare providers but also laboratories, clinical research organizations, biotech and digital health disruptors, accreditation organizations, pharmaceutical companies, health plans, and others. Healthcare truly is everywhere.

Sumaya: I advise hospitals and healthcare systems on strategic transactions and regulatory matters. Currently, I am working on a high-profile, cross-market transaction on behalf of a health system client that will be acquired by an integrated healthcare delivery system. The parties’ estimated combined revenue at closing will be $102.3 billion—about five times greater than the next highest combined revenue of a health system merger in 2023.

What types of cases/deals do you work on?

Greg: The McDermott Healthcare Department prides itself on a deep and broad array of subject matter experts that can serve a wide variety of healthcare industry clients. If it has to do with healthcare—we have got it covered. This has afforded both Sumaya and me the opportunity to work on front-page transactions and extremely complex regulatory questions every day.

How did you choose this practice area?

Greg: During public health graduate school, I had a work study job at the Centers for Disease Control that turned into a full-time microbiologist position focusing on antimicrobial-resistant healthcare infections. When the Affordable Care Act was enacted in 2010, I had been debating a Ph.D. and decided the ACA gave me an opportunity to transition industries without disregarding my prior experience. 

Sumaya’s interest in healthcare stems from her background in medical ethics and health policy, where her scholarship focused on reducing disparities in healthcare and assuring equitable access to care. 

For both of us, the aspirational nature of the ACA to improve health access, affordability, and outcomes has motivated and undergirded our practices. Despite having different practice types, we each advise clients to this day on the multitude of industry changes that were born out of the ACA and the challenges that come with the economics of shifting from volume to value-based care.

What is a typical day like and/or what are some common tasks you perform?

Sumaya: While there is no typical day, we have become accustomed to learning something new every day! Being an effective healthcare lawyer requires that we stay apprised of legal and regulatory developments affecting the healthcare industry and as we support our clients through challenges and opportunities. We each also spend considerable time mentoring more junior lawyers and supporting the firm in its diversity, equity, and inclusion initiatives.

Greg: Sumaya said it well: a typical day is predictably unpredictable. 

What training, classes, experience, or skills development would you recommend to someone who wishes to enter your practice area?

Greg: Of course, law students should take healthcare-specific courses if they are offered, but the most valuable courses I took were Administrative Law and Advanced Legal Research. The U.S. healthcare system is heavily regulated, with guidance more likely found in agency materials than case law. Understanding how regulations are promulgated (and where to find them) is integral to staying up to date. I also cannot underemphasize the importance of “speaking healthcare” for anyone wishing to enter this discipline, which can be accomplished by reading industry blogs and listservs, writing on emerging regulatory developments, participating in bar associations, and generally being curious.

Sumaya: I encourage any form of experiential learning that simulates client service. Client clinics and models of legal practice, like mock negotiations, board presentations, and trials are all invaluable experiences, regardless of subject matter area. I also encourage networking early and often with healthcare legal practitioners. One of the easiest ways to do so is by getting involved with local and national healthcare bar organizations. I started as a student member of the Illinois Association of Healthcare Attorneys and worked my way up to being a member of its Board of Directors.     

What is the most challenging aspect of practicing in this area?

Healthcare represents at least one-fifth of the U.S. economy, with everyone consuming healthcare services at some point in their lives. But the ever-changing regulatory landscape makes health law an often confusing morass to navigate. The confusion creates an equally challenging and rewarding specialty practice area with clients rarely turning to us because they have an easy question. Health lawyers are lifelong learners and anyone—junior or senior—can add value by studying the newest laws and regulations and explaining clearly and succinctly how those change how our clients can or should do business.      

What is unique about your practice area at your firm?

Our attorneys are thought leaders across the industry, with many of the members of the Healthcare Practice Group serving in leadership positions at the firm and in local, state, and national organizations, and we are beyond fortunate to have a phenomenal team of staff professionals who drive business development strategies, expand client relationships, and increase brand recognition. This team effort to strive to be #alwaysbetter has resulted in a sterling reputation with clients and McDermott being named as Vault’s #1 Healthcare firm for seven consecutive years while accumulating numerous other best-in-class rankings.   

How do you see this practice area evolving in the future?

Healthcare is both cyclical and unpredictable. In many ways, we expect a “back to the future” in how providers and payors align themselves (i.e., greater coordination and alignment between those who provide care and those who pay for care). In other respects, the lessons learned during the COVID-19 pandemic exposed significant discordance in how healthcare is received by many Americans. We anticipate that the industry will continue to explore how digital health and artificial intelligence can make healthcare more convenient, equitable, accurate, and affordable, and the complex regulatory and reimbursement frameworks of these emerging areas will keep healthcare lawyers in high demand. 

What kinds of experience can summer associates gain at this practice area at your firm?

Summer associates in the Healthcare Department can expect to sample a variety of corporate and regulatory matters which will continue upon their return as junior associates. Summer associates are expected to engage on real client matters and will be exposed to key health laws and regulations, see how supervising lawyers advise clients in digestible and pragmatic ways, and provide meaningful support by researching emerging areas of health law. On the corporate side, summer associates and junior healthcare lawyers can expect to prepare or revise corporate governance documents and board resolutions and complete legal, operational, and financial due diligence. On the regulatory side, summer associates and junior healthcare lawyers can expect to research state and federal healthcare laws, update licenses/permit registrations, and draft or edit clients’ policies and procedures to address areas of detected noncompliance or operational deficiencies.