John W. Jones, Jr. is a partner and chair of the Health Care Transactions and Regulatory Practices of the Health Sciences Department of Pepper Hamilton LLP, resident in the Philadelphia office. He is a past member of the firm’s Executive Committee. Additionally, he leads the firm’s Health Care Transactions Practice, Acute Care and Hospitals and Health Systems Practice, Group Purchasing and Buying Cooperative Practice, Long-Term Care Organizations and Pharmacy Industry practices, and is a member of the White Collar and Corporate Investigations Practice Group. Mr. Jones concentrates his practice in corporate and health care matters. Mr. Jones represents financial sponsors and health care providers and suppliers throughout the supply chain on a wide range of corporate, M&A and regulatory and compliance issues. On the acute care side, he has significant experience in nonprofit and for-profit health system affiliations, member substitutions and strategic transactions.
Specifically, Mr. Jones represents public and private companies with a national presence in M&A and commercial transactions involving medical and pharmaceutical supply chains and group purchasing and acute and post-acute providers (including pharmacy, rehab, home health and hospice) with a specialized expertise in federal and state health care regulations, including fraud and abuse and anti-referral (Anti-Kickback Statute and Stark). Mr. Jones has been representing health care providers and suppliers, on the transactional and regulatory side for more than 20 years. He has significant experience in M&A, compliance, regulatory and structural governance matters. He has brought the health care M&A 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, combo, and long-term care pharmacies, group purchasing organizations (GPOs), networks and aggregators, physician practice management companies, long-term care organizations, pharmaceutical manufacturers, medical device companies, vendors and suppliers, hospitals and health systems and specialty hospitals, medical staffs, ambulatory surgery centers (ASCs), 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:
- $750 million+ equity investment in an outpatient pharmacy management company
- $500 million+ acquisition of an inpatient pharmacy management company
- $3.1 billion sale of a national assisted living company
- $500 million+ acquisition of a national pharmacy
- $1 billion+ sale of a group purchasing organization
- regional health systems affiliation
- health system physician roll-ups
- Cleveland Clinic’s formation of the first clinically based GPO
- cancer hospital in disposition of cancer center
- Senior Care Centers (TX) in several complex, $100 million+ strategic transactions in the skilled nursing facility and post-acute care space, including pharmacy and home health
- $100 million+ sale of a urology practice management company
- $120 million sale of a rehabilitation provider
- private equity sponsor’s investment in a radiology services company
- multiple physician joint ventures with a national dialysis provider
- $1 billion sale of a national institutional pharmacy to a private equity sponsor
- $500 million merger of national oncology groups
- $100 million+ sale of dental practice management company
- $150 million+ consolidation and sale of OB/GYN practice management company
- $100 million+ merger of national pharmacies
- several $25 million+ provider/supplier acquisitions and dispositions.
Mr. Jones also counsels health care companies throughout the supply chain 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).