“Sources praise his business acumen and cite his expertise in healthcare regulations.” -- Chambers USA 2016
John W. Jones, Jr. is a partner in the Commercial Department of Pepper Hamilton LLP, resident in the Philadelphia office. He is a member of the firm's Executive Committee. Additionally, he is chair of the firm's Health Care Transactions Practice Group, Acute Care and Hospitals and Health Systems Practice, Group Purchasing and Buying Cooperative Practice Group, Long-Term Care Organizations Group and Pharmacy Industry Group, co-chair of the Health Care Services Practice Group, member of the Life Sciences Practice Leadership Committee and a member of the White Collar and Corporate Investigations Practice Group. Mr. Jones concentrates his practice in corporate and health care matters.
Specifically, Mr. Jones represents public and private companies, with a national presence in transactions involving pharmacy and medical and pharmaceutical supply chains and group purchasing and acute and post-acute providers with a specialized expertise in federal and state health care regulations, including fraud and abuse (Anti-Kickback Statute and Stark). Mr. Jones has been representing health care providers and suppliers, on the transactional and regulatory side for almost 20 years. He has significant experience in M&A, compliance, regulatory and structural governance matters. He has brought the transactional and regulatory skill set into one practice, creating significant efficiencies for clients on deals. He represents private equity funds and their portfolio companies, venture capital firms, hospitals and health systems, retail specialty and long-term care pharmacies, group purchasing organizations (GPOs), physician practice management companies, long-term care organizations, pharmaceutical manufacturers, medical device companies, vendors and suppliers, hospitals and health systems, medical staffs, ambulatory surgery centers (ASCs), specialty hospitals, outpatient diagnostic centers, including MRI and lithotripsy centers, biotechnology companies, research institutions and laboratories, contract research organizations (CROs), including information technology companies, management and consulting companies, third-party administrators, staffing companies and other health care organizations. His experience handling white collar matters, including audits and investigations, provides significant value on the M&A side and with other corporate transactions.
Mr. Jones has represented and advised on:
Mr. Jones also counsels health care companies on company formation, organization, governance and risk management issues. Additionally, his practice includes counseling these organizations on corporate planning, finance and structuring of transactions, including mergers, acquisitions (including platform add-ons and roll-up acquisitions) and dispositions, joint ventures, restructuring and reorganizations, and collaborations, partnering arrangements and strategic alliances. He has significant experience in regulatory issues impacting commercial health care transactions. These generally include issues under fraud and abuse laws, (including the federal Anti-Kickback Statute), Stark, civil monetary penalties law, false claims act, health care fraud statutes, HIPAA, as well as billing, reimbursement and claims issues, including issues under Medicare Parts A, B & D, Medicaid and commercial payor requirements. Regarding reimbursement, Mr. Jones also counsels health systems and physician groups on corporate compliance, national and local coverage decisions, GME and teaching physician rules, documentation issues, assignment and reassignment rules, supervision requirements, "incident to" rules, E&M guidelines, private contracting, independent contractors and reimbursement appeals.
Mr. Jones also has experience with traditional health care issues, such as hospital-physician relations, including exclusive contracts and medical staff privileges and credentialing (including economic credentialing and pay-for-performance issues), non-profit and reserved power issues, attorney general and orphan's court issues and procedures, certificates of need and licensure, professional courtesy and patient rights issues, including care access and delivery issues. Additionally, Mr. Jones represents providers and suppliers in connection with negotiating and drafting managed care agreements. He also has experience with the unique issues facing academic medical centers and nonprofit health care institutions and with the legal issues presented by new health records and electronic medical information technologies, including informatics and e-commerce, telemedicine, electronic health records and electronic medical communications. Mr. Jones counsels product manufacturers and life science companies, including biotechnology companies on a range of investment, governance, contractual and regulatory issues and represents sponsors, academic institutions, researchers, investigative sites, and CROs in the preparation of protocols, informed consent and authorization forms, collaborative research agreements and counseling these organizations on compliance issues under applicable HIPAA and FDA requirements.
Mr. Jones is a member of the adjunct faculty at Drexel University Kline School of Law, and teaches the Health Law Practicum in the Health Law Concentration, to upper level students. He also is a member of the Health Law Concentration's Board of Advisors.
Mr. Jones speaks and writes frequently on health-related topics. He is a contributing editor to Physicians News Digest, a regular contributor AHLA's Health Law Digest, and he was a contributing author to Guide to Medical Privacy and HIPAA (Thomas Publishing Group, 2002) and The Health Laws of Pennsylvania, Pennsylvania Bar Institute (2000). He has been on the faculty of the Pennsylvania Bar Institute, the Health Law Institute, Medical Education Services, the Medical Records Institute and Lorman Education Services for programs on HIPAA privacy and security.
During law school, Mr. Jones worked as a law clerk and as a health policy intern at the Pennsylvania Department of Health, where he co wrote "Department of Health - Powers and Duties under Pennsylvania Law" (rev. 1996).