With a wide breadth of experience in the health care sector, J. Everett Wilson focuses his practice on assisting clients meet the challenges of a complex and highly regulated industry. A true “regulatory” attorney with a business background, Everett represents health care providers and other health care and health care insurance entities on issues related to Medicare and Medicaid, operations, managed care, and the regulatory and business issues specific to health care M&A.
He utilizes his comprehensive understanding of the health care industry to provide strategic counsel on a full spectrum of health care legal and business issues and projects. In that role, Everett regularly assists clients in the implementation of their strategic vision, whether by way of growth, implementation of newer business models and/or “best practices”, expansion of business lines, and/or ultimate sale. Of particular note, is his extensive experience in the Medicare Advantage and Medicaid managed care arena, with a particular emphasis on full-risk arrangements and the regulatory and business issues related to the same.
He often advises clients that operate in the intersection between payors and providers and the more recent trend towards the integration of those sectors. In that respect, he is experienced in the establishment of provider based managed care companies, discount plans, pre-paid plans, TPA’s, provider networks and MSOs. Further, while he advises established health care clients, he also advises health care entrepreneurs, private equity, and other investors relative to their foray into particular sectors of the health care industry and, in particular, the Florida market place.
Over almost 30 years of practice, Everett has successfully represented many health care professionals, providers, and insurers at both federal and state level on numerous matters, including:
- Licensing and Changes of Ownership
- Disciplinary and Enforcement proceedings
- Medicare and Medicaid Provider Issues, including payment suspensions, pre-payment reviews, revocations, and enrollment
- Medicare and Medicaid Audits and Appeals
- Reimbursement and Overpayment Appeals
- Medicare MRA Audits
- Regulatory and Compliance Matters (including Fraud and Abuse)
- Provider Operations
- Medicare Advantage and Medicaid Managed Care
- Managed Care Contracting
- Non-Compete Agreements
- Health Care Joint Ventures
- Health Insurer Liquidations and Receiverships
Everett has additional experience on the transactional side, assisting clients in the purchase or sale of a wide variety of health care entities and actively represents both buyers and sellers in middle market transactions.