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Mr. Dowell practices in the areas of healthcare, regulatory and corporate law. With more than 30 years of experience, he represents clients in a variety of sectors within the healthcare industry, including federally qualified health centers, health plans, PPOs, HMOs, Medicaid Managed Care Plans, Medicare Advantage Plans, PACE Programs, employer self-insured plans, pharmacy benefit managers, pharmaceutical manufacturers, retail pharmacies, long-term care pharmacies, specialty pharmacies, compounding pharmacies, mail order pharmacies, wholesale drug distributors,  hospitals, health systems, long-term care providers, physician organizations, management companies, and ancillary service providers.  

Mr. Dowell counsels clients in a variety of corporate and contractual transactions, including mergers and acquisitions, joint ventures, affiliations, licensing, financing and services-related transactions. He also advises clients in federal and state fraud and abuse matters, compliance program development, governmental audits and investigations, Medicare, Medicaid, HIPAA and data privacy, meaningful use of electronic medical records, licensing, health care reform delivery models (including ACOs, value-based payments, and pay-for-performance), concierge medicine, and managed care law.  

Mr. Dowell has published several articles and spoken at conferences regarding various health law issues, including compliance, fraud and abuse, pharmacy law, federally qualified health centers, HIPAA privacy and security, and managed care contracting and payment disputes.

Mr. Dowell has particular experience in the following areas:

Federally Qualified Health Centers 

Mr. Dowell has significant experience counseling nonprofit health care organizations, including state licensed primary care clinics, community health centers, and federally qualified health centers, on a broad range of legal matters. He provides guidance on start-ups, affiliations and joint ventures, governance, 340B drug discount programs, conflicts of interest, mergers and acquisitions, compliance programs, lobbying and political activities, and grant management. 

Pharmacy Law 

Mr. Dowell counsels and represents pharmacies (including chain, independent, long-term care, specialty, compounding, nuclear, veterinary, and prison) in all 50 states, and pharmacists, pharmaceutical manufacturers, wholesalers, pharmacy benefit management companies, Medicare Part D Plans, drug wholesalers, drug and dietary supplement manufacturers, and retail medical oxygen dealers. Mr. Dowell has counseled such clients regarding licensure, pharmacy regulatory matters, contracts, acquisitions and sales, federal and state laws and regulations governing pharmacy and controlled substances, third party payer audits, matters before State Boards of Pharmacy and Drug Enforcement Administration, and HIPAA privacy and security compliance.

Managed Care Plan Licensure and Regulation 

Mr. Dowell provides health insurers and other managed care organizations regulatory advice concerning compliance with various state and federal health care and state managed care plan and insurance laws and regulations, including Medicare Advantage, Medicaid Managed Care, PACE programs, the Affordable Care Act and other health reform initiatives, and obtain help them obtain regulatory approvals from federal and state agencies, including the Centers for Medicare and Medicaid Services, and The California Department of Managed Health Care, Department of Insurance, and Department of Health Care Services. He represents clients in related federal and state agency enforcement matters and transactional matters, including mergers and acquisitions and joint ventures between managed care plans, insurers and providers. 

Physician Organizations 

Mr. Dowell counsels individual physicians, medical groups, independent practice associations (IPAs), management services organizations (MSOs), physician practice management companies, accountable care organizations, and other physician organizations, on organizational, operational and regulatory matters, mergers and acquisitions, joint ventures, affiliations, managed care contracting, third party reimbursement, hospital-physician contracting, federal and state fraud and abuse and self-referral laws, Medicare and Medicaid audits and other federal and state compliance issues.

HIPAA Privacy and Security 

He has substantial experience in counseling health care industry clients on all aspects of information privacy and security issues, including state laws and the HIPAA Privacy and Security rules. Mr. Dowell conducts risk assessments, drafts privacy policies and advises on the development of other privacy safeguards. He helps clients respond to complaints and privacy breaches. He also helps clients negotiate the full range of health care technology contracts, including general software licenses, electronic medical records agreements, and data use agreements.

Professional Background

Mr. Dowell joined Hinshaw & Culbertson LLP in December 2009. Previously he was a co-chair of the Health Care Industry Group at Theodora Oringher Miller & Richman PC in Los Angeles.

Mr. Dowell began his legal career in 1983 as a staff attorney with the National Health Law Program in both Washington, D.C. and Los Angeles. In 1989, he became corporate counsel to CIGNA Healthcare of California. From 1991 to 2006, he was Chair of the Health Care Practice Group at Miller & Holguin in Los Angeles.

Professional Affiliations

  • California Society for Healthcare Attorneys, Education Committee, Appointed Member
  • American Bar Association, Health Law Section
  • State Bar of California, Business Law Section
  • Los Angeles County Bar Association, Health Law Section, Past Chair
  • American Health Lawyers Association
  • American Society for Pharmacy Law

Honors & Awards

  • Named annually since 2005 to the Super Lawyer list published in Southern California Super Lawyer magazine and Los Angeles magazine

Representative Matters

Some of Mr. Dowell’s representative transactions include:

Hospitals and Health Systems

  • Drafted and negotiated medical director and hospital-based physician coverage agreements for radiology, emergency medicine, anesthesiology and pathology
  • Counseled numerous hospitals on all aspects of licensure, certification and accreditation, including Medicare and Medicaid enrollment, change of ownership, and operational issues

Managed Care Plans and Insurers

  • Development and formation of Medicare Advantage Plans, Medicaid HMOs, commercial plans, and specialized health plans (vision, dental, chiropractic and mental health)
  • Drafting, negotiating, and analyzing fee-for-service and capitation physician organization and managed care plan contracts and related documents

Physician Organizations/Management Companies

  • Representation of physicians and medical groups, including IPAs, in the review, analysis and negotiation of all types of managed care plan agreements, including multi-year payor agreements
  • Development of physician and dental practice management services agreements to conform to corporate practice of medicine, fee splitting, and anti-kickback laws

Mergers and Acquisitions

  • Structured, negotiated and documented a $80 million sale of a management company and affiliated professional medical corporations located in multiple states to a large, publicly traded company and its affiliated professional medical corporations
  • Conducted health care regulatory due diligence and general corporate representation of client in its acquisition of a four-hospital Health System

Compliance Program Counseling and Defense

  • Developed and implemented a Corporate Compliance Plan, code of conduct, and policies and procedures for a nonprofit integrated delivery system comprised of an HMO, physician organization, federally qualified health clinic, and community health programs
  • Conducted an internal investigation for a Medicare and Medicaid HMO to determine compliance with Medicare marketing requirements

HIPAA Privacy and Security

  • Counseled hospitals and health systems, health plans, insurers, governmental entities, physician organizations and personal health record vendors with respect to a wide range of privacy and security compliance issues

Presentations

Mr. Dowell also speaks regularly to many organizations, including the American Association of Health Plans, American Health Lawyers Association, California Association of Dental Plans, California Association of Health Plans, California Black Health Network, National Black Prosecutors Association, National Dental Association, National Health Law Program, National Health Lawyers Association, State Bar of California and the Health Care Law Section of the Los Angeles County Bar Association. His presentations include:

  • "Mid-Level Practitioners: A Primer on the Legal Issues Affecting a Growing Segment of the Health Care Delivery Workforce," Orange County Bar Association
    Health Care Law Section Meeting, Newport Beach, California, September 2014.
  • "Fraud & Abuse," California Society for Healthcare Attorneys Annual Meeting & Spring Seminar, Olympic Valley, California, April 2014.
  • "EHR, PHI, HIPAA, HITECH: Deciphering the Alphabet Soup for Data Privacy and Security in Health Care Delivery," 88th Annual Convention & Exhibits, National Bar Association, Miami, Florida, July 2013.
  • "The Omnibus Rule and Its Impact on HIPAA Compliance," National Bar Association Health Law Section Webinar Series, June 2013.
  • "A Map to Healthcare Reform Compliance," Minority Corporate Counsel Association's 12th Annual CLE Expo, San Diego, California, March 2013.
  • “HIPAA Security Breaches and Cyber- Liability,” Hinshaw’s Annual Health Care Conference, Lisle, Illinois, November 2012.
  • “Defending Against False Claims Actions and Identifying the Other Fraud & Abuse Implications of Managed Care Litigation,” American Conference Institute’s 2nd Advanced Forum on Management Care Disputes and Litigation, Phoenix, Arizona, November 2011.
  • “Basics of Health Plan Law,” California Society of Healthcare Attorneys 2011 Fall Seminar & Back to Basics, Los Angeles, California, November 2011.
  • “Effective Collaboration Between Hospitals and Federally Qualified Health Centers/Rural Health Centers,” National Association of Health Services Executives 26th Annual Education Conference, Henderson, Nevada, October 2011.
  • “Managed Care Contracting After Health Care Reform,” Hinshaw’s 2010 Health Care Conference, Lisle, Illinois, November 2010.
  • “Healthcare Fraud and Abuse in a Tougher Enforcement Environment,” Strafford Publications, Inc., live webinar, April 2010.
  • “Recent Healthcare Fraud Enforcement Efforts Under the Obama Administration and Impact to Plans, Payors and Providers,” American Health Lawyers Association, live webinar, February 2010.

Publications

Mr. Dowell is a prolific author. A selection of his publications includes:

Hinshaw Publications

Education

J.D., Indiana University Maurer School of Law

B.S., Pharmacy, Purdue University

Admissions