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Debbi M. Johnstone

Head of Life Sciences and Healthcare, United States

Debbi M. Johnstone

Houston

T:+1 713 651 5335

Debbi Johnstone joined the Houston office in 2008. As an accomplished lawyer, and partner, with over 30 years of experience, Debbi's practice focuses exclusively on the health care industry.  She has worked on matters involving mergers and acquisitions, joint ventures, corporate compliance, hospital-physician contracting, and physician recruitment and employment. 

Debbi has a special practice focus on compliance and reimbursement matters. She has significant experience advising clients on federal and state government program anti-kickback, physician self-referral (Stark Law), false claims, civil monetary penalty and related sanctions issues, as well as all aspects of coverage and payment under Medicare and Medicaid.

She was certified in Health Law by the Texas Board of Legal Specialization in 2002.

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  • Education

    JD, cum laude, Indiana University School of Law, 1980
    BA, Political Science, Northwestern University, 1977

  • Representative experience

    Transactional

    • Represented, as lead counsel, a non-profit health care system in contributing two hospitals to newly formed joint venture with a non-profit health care system
    • Represented, as lead counsel, a non-profit community hospital in its acquisition by a national non-profit hospital system
    • Represented, as lead counsel, a hospital system in the lease and subsequent acquisition of a public hospital
    • Represented, as lead counsel, the combination of a satellite facility of a non-profit hospital and two physician-owned ambulatory surgery centers into a new, separately licensed for-profit acute care hospital physician joint venture
    • Represented, as lead counsel, non-profit health care systems in the acquisition of urgent care centers, including formation of a joint venture between a non-profit health system and a for-profit development firm to operate urgent care centers
    • Represented, as lead counsel, non-profit health care systems in the development of pediatric inpatient hospital and home health joint ventures
    • Represented, as co-counsel, a newly formed joint venture between a medical school and a non-profit hospital system to own and operate a hospital
    • Represented hospitals in the formation and syndication of hospital-physician joint ventures for ambulatory surgery centers
    • Represented multiple hospital systems in the acquisition of physician practices and employment of physicians

       

    Regulatory

    • Represented hospital in defense and settlement of false claims case involving hospital employed physician compensation and allegations under the Stark and anti-kickback laws
    • Represented hospitals in self-disclosure of potential Stark Law and anti-kickback law violations to CMS, HHS OIG, the Department of Justice, and the Texas Medicaid program
    • Represented hospitals concerning Medicare and Medicaid audit and overpayment matters, including voluntary refunds to program intermediaries and carriers
    • Represented numerous health care providers in structuring arrangements to comply with the Stark Law, federal and state anti-kickback laws, corporate practice of medicine restrictions and related health laws
  • Admissions
    • Texas State Bar
  • Rankings and recognitions
    • Lawyer of the Year, Houston: Healthcare Law, Best Lawyers, 2012
    • The Best Lawyers in America, Best Lawyers, 1995-2018
    • Texas Women Lawyers, Best Lawyers, 2014
    • Chambers USA, Texas: Healthcare, Band 1 (2014-2016, 2018), Chambers & Partners, 2005-2018
    • Chambers USA, Nationwide: Healthcare (Transactional), Band 2 (2014-2015), Chambers & Partners, 2011, 2013-2018
    • Texas Super Lawyer, Healthcare, Thomson Reuters, 2003-2017
    • Texas Super Lawyers, Top 50 Women, Thomson Reuters, 2008, 2010-2014
    • Texas Super Lawyers, Top 100 Houston, Thomson Reuters, 2010, 2012-2014
    • Texas Top Rated Lawyer, LexisNexis Martindale-Hubbell, 2012-2017
  • Publications
    • Co-Author, "CMS Issues Frequently Asked Questions Refining Self-Discovery Protocol," Fulbright Briefing, May 2012
    • Co-Author, "Federal Agencies Coordinate in the Issuance of Much-Anticipated Guidance on Accountable Care Organizations," Fulbright Briefing - Accountable Care Organization Task Force, April 2011
    • Co-Author, "Anyone For Phase Four?  CMS Issues Additional Final Stark Regulations," Fulbright Briefing, August 2008
  • Speaking engagements
    • Presenter, "Top Ten Challenges in Structuring Healthcare Transactions," Client Seminar, Norton Rose Fulbright, Denver, Colorado, February 2015

    • Co-Presenter, Top Ten Challenges in Structuring Hospital-Physician Affiliations in 2015, Annual Client Seminar, Norton Rose Fulbright, Austin, Texas, January 2015

    • Presenter, Legal Developments Impating Compensation in Physician Employment and Personal Services Arrangements, Texas Hospital Association Health Law Conference, Austin, Texas, October 2014

    • Co-Presenter, Deals Gone Wild, Annual Client Seminar, Norton Rose Fulbright, January 2014

    • Co-Presenter, "Physician-Hospital Alignment Strategies:  What's Waning, Working and On the Horizon," Texas Hospital Association Health Law Conference, Austin, Texas, October 2013

    • Co-Presenter, "Structuring Employed Physician Compensation in the Wake of Tuomey and Halifax," Web Seminar, Fulbright & Jaworski, LLP, September 2013

    • Co-Presenter, "Hospital-Physician Acquisition and Employment Agreements," Web Seminar, Fulbright & Jaworski, LLP, Houston, Texas, December 2011

    • Presenter, "Compliance Issues With Accountable Care Organizations," Fulbright & Jaworski, LLP Legal Issues Boot Camp For Compliance Professionals, Houston, Texas, June 2011

    • Presenter, "Compliance Basics: Stark, Anti-Kickback and False Claims," Fulbright & Jaworski, LLP Legal Issues Boot Camp For Compliance Professionals, Houston, Texas, June 2011 

    • Presenter, "Fair Market Value Issues in Physician Integration Strategies," Fulbright & Jaworski, LLP Legal Issues Boot Camp For Compliance Professionals, Houston, Texas, June 2011

    • Co-Presenter, "Health Regulatory Issues," Fulbright & Jaworski, LLP Health Care Futures Seminar, Phoenix, Arizona, March 2011

    • Presenter, "Legal and Regulatory Issues Applicable to Physician Integration Strategies," Healthcare Landscape 2011, San Antonio, Texas, January 2011

    • Co-Presenter, "Legal Issues Challenging Health Care Reform," University of Texas Health Law Program, Houston, Texas, April 2010

    • Co-Presenter, "Beneficiary Inducement Issues," AHLA Fraud & Abuse Program, Baltimore, Maryland, October 2009

    • Presenter, "Stark and Anti-Kickback Law Primer," Tomball Regional Hospital, Tomball, Texas, July 2009

    • Co-Presenter, "Health System-Owned Medical Practices:  The Legal and Practice Administrator Perspective," Texas MGMA Annual Meeting, Arlington, Texas, May 2009

    • Co-Presenter, "Physician Integration Strategies," Beard Group Physician Agreements & Ventures California, Chicago, Illinois, September 2008

    • Co-Presenter, "What Can Doctors Do?" University of Texas Health Law Conference, Houston, Texas, April 2008

    • Presenter, "Hospital Physician Recruitment:  New Approaches to Compliance," AHLA Physician Organizations/Hospitals and Health Systems Law Institutes, Las Vegas, Nevada, February 6, 2007

    • Co-Presenter, "Physician Cancer Center Ventures in Radiation Therapy and Imaging," Beard Group Physician Agreements & Ventures Conference, Chicago, Illinois, November 2006

    • Presenter, "Hospital-Physician Recruitment: Navigating the Landmines," AHLA Physicians/Hospitals and Health Systems Law Institutes, Fort Lauderdale, Florida, February  2006

    • Presenter, "Hospital-Physician Recruitment: Navigating the Landmines," AHLA Physicians/Hospitals and Health Systems Law Institutes, Tucson, Arizona, February 2005

    • Presenter, "Joint Ventures," BKD Advanced Strategies for Reimbursement," Kansas City, Missouri, December 2004

    • Co-Presenter, "Radiation Therapy Ventures," Beard Group Physician Agreements and Ventures, Chicago, Illinois, November 2004

    • Presenter, "Physician Recruitment to Existing Groups: Navigating the Legal Landmines," HCCA Physician Practice Compliance Conference, San Francisco, California, October 2004

    • Presenter, "Physician Recruitment, Compensation and Bonuses: A Very Slippery Slope," 26th Annual Health Law Forum, Brody School of Medicine, East Carolina University, Greenville, North Carolina, September 2004

    • Presenter, "Hospital Support in Recruiting to Existing Groups," AHLA Hospitals and Physicians Law Institutes, Hollywood, Florida, February 2004

  • Memberships and activities
    • American Bar Association - Health Law Section
    • Texas Bar Association - Health Law Section
    • Houston Bar Association, Health Law Section Chair (2004 - 2005)
    • American Health Lawyers Association
    • University of Houston Law Center, Adjunct Professor
    • Texas Board of Legal Specialization - Health Law Exam Commission (2006 - 2011)
    • DePelchin Children's Center
      • Board of Directors (1997 - present)
      • Chairman of Board (2010 - 2011)