Francis & Totusek, L.L.P. has a special interest in representing health care providers in the unique legal issues that they encounter. Since 1995, the firm has represented health care companies and organizations in a variety of reimbursement disputes and litigation matters, including the following:

Hospital Issues:

The firm is involved in advising hospitals, hospital systems, and their affiliated entities with regard to disputes of a commercial nature, including particularly those involving physician recruitment/relocation matters; reimbursement claims involving managed care payors, ERISA plans, workers compensation and prompt-pay issues, government programs; and hospital liens. We also review hospital contracts, including managed care agreements, leases, and other contractual relations with physicians.

Regulatory, Reimbursement and Compliance:

The firm counsels health care providers and other entities concerning state and federal regulatory issues, including Stark compliance, illegal remuneration, and corporate practice of medicine. We advise health care clients on Medicare and Medicaid reimbursement and billing issues; represent clients charged civilly with Medicare or Medicaid fraud and abuse; assist in preparing and implementing aspects of corporate compliance programs; assist health care providers in obtaining Medicare/Medicaid reimbursement; and handle reimbursement disputes in state and federal court. In addition, the firm has extensive experience in assisting hospitals in all matters relating to physician recruitment/relocation agreements.


The firm has represented health care providers with numerous issues involving medical office building (MOB) leases; medical equipment transactions; promissory notes between the provider and the physician; and construction and remodeling disputes.

Hospital Liens:

The firm has done extensive work in recovering on hospital liens under the Texas Hospital Lien Statute. The firm has handled matters dealing with many hospital lien issues, including the definition of “reasonable and regular rate”; when settlement proceeds are considered “paid”; improper distribution of settlement proceeds between wrongful death and survival causes of action; minor defects on the face of the lien; and the hospital’s rights under the Medicare Secondary Payor Statute to pursue its lien rights instead of accepting Medicare payments.


The firm attorneys have extensive experience representing health care providers and practitioners in litigation related to all of the areas identified above, including prosecuting lawsuits, defending lawsuits, and handling appeals of lawsuits in many counties throughout Texas, in both state and federal courts. In connection with the firm’s litigation practice, it has handled numerous arbitrations administered by the American Arbitration Association and the American Health Lawyers Association, and the firm has represented clients in numerous mediations.


Blair G. Francis
Thomas G. Seidler

Mark E. Gannon