J. Peter Rich

J. Peter Rich is a partner in the law firm of McDermott Will & Emery LLP and is based in the Firm’s Los Angeles office. He co-chairs the Firm’s Insurance / Payors Affinity Group.

Peter has practiced almost exclusively in the health law field for 35 years, and routinely advises hospitals, health plans and other health insurers, medical groups, integrated systems, and other health industry clients on a wide variety of transactions, health regulatory matters, hospital-medical staff matters and health industry disputes.

Peter was chosen as the sole 2015 “Los Angeles Lawyer of the Year” in administrative/regulatory law by U.S. News/Best Lawyers. McDermott Will & Emery's Health Industry Advisory Practice Group has been twice named “Healthcare Team of the Year” by Chambers USA (Most recently for 2013). Peter has also been recognized in 2015 and past years by U.S. News/Best Lawyers in America®, in the categories of health law and administrative law, and by Super Lawyers® in the category of health care law. Peter has been recognized as a “2013 Top Rated Lawyer in Healthcare” by American Lawyer Media and Martindale-Hubbell.™ The 2013 edition of US Legal 500 states that “J. Peter Rich is very knowledgeable, innovative in thought and specific in delivery.”

Peter has formed and restructured many types of managed care organizations, including Pioneer, Medicare Shared Savings Program, and commercial Accountable Care Organizations (ACOs) (and has also advised ACOs and providers on the new CMS Bundled Payments contracts between health systems and CMS-contracted conveners as well as, related bundled payments provider contracts), other types of physician-hospital organizations, and similar integrated health care delivery systems, as well as health maintenance organizations (HMOs) and other types of health plans, including restricted and full-service Knox-Keene Health Care Service Plans specialized behavioral health, vision, dental, and chiropractic plans. Peter has advised both payors and providers on the full range of accountable care and other managed care contracts, as well as numerous specialized, restricted and full-service health plan licensing applications and other regulatory matters arising under California’s Knox-Keene Act and related matters involving the California Department of Managed Health Care. He has served as special health care counsel in several bankruptcies involving health plans, IPAs, and hospitals, and in that role has successfully advised on restructuring, regulatory compliance, and asset sales. Peter has also extensively advised hospitals and other affiliated providers as well as medical staffs in such legal areas as joint ventures and other transactions, medical staff bylaws and peer review matters, the corporate practice of medicine and fee-splitting, EMTALA, state licensing and CMS enforcement actions and other health regulatory matters. He has served for over a decade as outside general counsel to the board of directors of one of the nation’s largest and most successful physician-owned malpractice insurance cooperative interindemnity arrangements, and has also provided legal assistance in connection with the creation of risk-retention groups and other physician-owned captive professional liability insurance companies.

Peter speaks and writes frequently in the field. Some of Peter’s recent presentations include: “Structuring Commercial ACOs: Payor and Provider Perspectives” for the Strafford Webinar on October 2, 2014; “Disruptive Physicians: Minimizing Liability for Negligent Credentialing, Poor Quality of Care, and Physician Conduct” for Strafford Webinar on July 30, 2014; “Commercial Accountable Care Arrangements: An Overview and Legal Primer” for the HCSC All-Attorneys Meeting on June 27, 2014; “Commercial Accountable Care Arrives in the Aloha State” for the 2014 ACO Growth Summit on January 20, 2014; “Commercial Contracting Opportunities for ACOs” for the ACO Bootcamp Webinar Series of the American Health Lawyers Association on May 2, 2013; “Disruptive Physicians: Key Legal Issues and Strategies” for the Strafford Webinar on March 28, 2013; “Evaluating Low-Volume Providers”, “Tools for Quality Improvement: Credentialing and Privileging”, and “Tools for Quality Improvement: Effective Peer Review” for the Yakima Valley Memorial Hospital Physician Leadership Program presented by The Institute for Medical Leadership on October 19, 2012; “PPACA Upheld: Key Payor-Related Issues” for the Healthcare Reform: Analyzing the Supreme Court Decision Strafford Webinar on July 10, 2012; “PPACA Upheld: Some Payor-Related Issues” for the California Society for Healthcare Attorneys Teleconference on July 3, 2012; “Accountable Care Organizations: Are There Workable Models?” for The Institute for Medical Leadership’s Chief of Staff Boot Camp on December 9, 2011 and February 24, 2012; “Key Compliance Issues in Structuring and Operating ACOs” for the Los Angeles County Bar Association 8th Annual Healthcare Law Compliance Symposium on October 13, 2011; and “Accountable Care Organizations: What Are They?” for the Physicians Insurance Association of America 2011 Medical Liability Conference on May 11 and 12, 2011.

Peter’s recent publications include “CMS ACO Proposed Rule to Extend One-Sided Risk Track While Incentivizing Performance-Based Risk” (December 19, 2014) (co-authored with Ariane Tschumi); “The Assault on the ACA in Federal Appeals Courts” (April 2014) and “ACA Still under Assault After Premium Tax Credits Upheld” for Law360 (February 2014) (both co-authored with Lauren D’Agostino); “An Overview of Insurance Payment for Health Care Services and Employee Welfare Benefit Plans,” Chapter 14 of the Health Law Practice Guide (revised 2011); “Eleventh Circuit Will Rule Soon on Constitutionality of Affordable Care Act” for BNA, Inc.’s Health Insurance Report (August 2011); “Virginia Federal Court Strikes Down Individual Mandate: What’s Next for the Health Reform Law?” for BNA’s Health Law Reporter (December 2010), “CMS Seeks Comments on New Standards for ACOs” and “AMA Adopts New Principles for ACOs” for the American Health Lawyers Association (November 2010), “The Potential Risk to Successful Hospital Integration Strategies Under the PPACA Posed by Physician Board Members’ Conflicts of Interest” for The Governance Institute E-Briefings (July 2010) and “Health Reform Hands Boards Big Responsibilities” (both co-authored with McDermott partner Michael Peregrine) for Trustee Magazine (May 2010); “Health Care Reform: ACOs and Developments in Coordinated Care Delivery, Shared Savings and Bundled Payments” (co-authored with McDermott partner Gary Davis) for McDermott, Will & Emery’s On the Subject (April 2010); the “California Supreme Court’s Prospect Medical Group Decision Prohibits Balance Billing by Emergency Services Providers in California” for the American Health Lawyers Association Practice Group Member Briefing (2009); and “What Rates are Health Plans Legally Obligated to Pay Non-Contracted Providers?” for the ABA Health Care Litigation Newsletter (2006).

Good to know

Areas of Practice 1) Affordable Care Act Resource Center, 2) Health - Hospital and Health System Representation, 3) Health - Insurance, 4) Health Care Law Reform, 5) Health Ventures/Physician Transactions, 6) Hospital and Health System Transactions and 7) Managed Care
Law School Harvard Law School (J.D., 1977)
Education University of California-Los Angeles (A.B., 1974)
Bar Member / Association California State Bar Association
Most recent firm McDermott Will & Emery LLP
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