"A compliance wiz, who is very tenacious and is the type of guy you want on your side in a negotiation." -- Chambers USA 2015
John W. Jones, Jr. is a partner in the Commercial Department of Pepper Hamilton LLP, resident in the Philadelphia office. He also is chair of the firm's Health Care Transactions Practice Group, 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 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, including, private equity funds and their portfolio companies, venture capital firms, pharmaceutical manufacturers, medical device companies, hospitals and health systems, medical staffs, ambulatory surgery centers (ASCs), specialty hospitals, outpatient diagnostic centers, including MRI and lithotripsy centers, physician groups, long-term care organizations, retail specialty and long-term care pharmacies, biotechnology companies, research institutions and laboratories, contract research organizations (CROs), medical suppliers, group purchasing organizations (GPOs), software vendors, including information technology companies, management and consulting companies, third-party administrators, staffing companies and other health care organizations. Mr. Jones has been representing health care providers, including pharmacies, on the transactional and regulatory side for 15 years.
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 as well as those affecting members in the medical and pharmaceutical supply chains, including pharmaceutical medical device manufacturers and suppliers, hospitals, physicians, GPOs, outsourcing companies and other providers. 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), 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 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).