Health Care Services

Organizational Structuring

We counsel health care providers of all types and sizes on company formation, organization, governance, risk management issues, and adapting new concepts to delivery, including the newer integrated care models of patient-centered medical homes (PCMHs) and accountable care organizations (ACOs), which arise out of the PPACA and its regulations and provisions.

We assist these new forms of health care providers in forging partnerships between patients, their families and caregivers, and physicians and payers to create a continuous, comprehensive care model; in developing more efficient relationships between physicians and institutional providers; and in controlling costs and improving quality of care.

Tax Exemption

We counsel providers on the organization and structuring of tax-exempt, nonprofit entities, including on a full range of tax issues associated with nonprofit organizations, including tax or tax-exemption matters as they affect health care operations, including tax-exempt financing, community health care benefits and Form 990, especially Schedule H. Our work has included assessing federal, state and local tax issues associated with the corporate reorganization of a health system and its for-profit and not-for-profit subsidiaries.

Community Health Care Needs

We help entities involved in community health care evaluate strategic structuring or restructuring and the collaborative strategies available to expand the delivery of services, achieve operational efficiencies, and better serve the needs of their communities. Pepper helps assess and plan for strategic structuring or restructuring; and assists clinics and other health care providers in considering and implementing strategic restructuring options such as administrative consolidation, joint programming and other forms of collaboration with other organizations. We counsel on the realities of competing with other entities, the organization of management services, joint ventures, and mergers.

Behavioral Health

We counsel organizations and providers on legal issues impacting behavioral health care, such as privacy and confidentiality (including the interplay between HIPAA and state laws concerning obligations of providers related to patient addiction, mental health and HIV/AIDS) as well as patient rights under federal and state law.


We help health care providers of all sizes and types in a myriad of matters related to system-wide governance. We have assisted in setting up hospital-physician joint ventures, provider networks, multi-service business organizations and ancillary service corporations. We advise on the composition and operation of boards of directors and trustees, and advise boards on all issues that arise in course of their leadership. This work includes helping board members of hospitals and health systems to identify and reinforce core competencies, to understand emerging issues and trends, and to develop tools and resources to bring to bear toward a variety of board practices.

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