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Today’s health care is provided through an ever-expanding web of entities, many of which operate in a complex, heavily regulated environment. This can include private, for-profit hospitals,  public hospitals and hospital districts, long term care facilities, rehabilitation centers and physician / professional practice groups.  From a law firm perspective, this runs from basic transactional work, to regulatory and administrative issues, and in some case, litigation, including malpractice defense.

Underwood serves a broad spectrum of the health care industry throughout the Southwest.  Historically, our practice has focused on three primary areas:  Serving all facets of long term care facilities (including acquisitions, financing, and regulatory matters), hospitals and hospital districts and professional practice groups. 

Long Term Care

Operators of these facilities work in a heavily regulated environment. They require experienced counsel to ensure compliance with Medicare and Medicaid requirements. They need lawyers familiar with and who regularly interact with state and federal agencies, such as the Texas Department of Human Services, the Centers for Medicare and Medicaid Services, the Provider Reimbursement Review Board, and many more. On a state level, for example, Underwood lawyers also navigate the administrative process with regular appearances before the Texas State Office of Administrative Hearings.


Underwood meets the needs of private and public hospitals and hospital districts. This has included regular representation of large, urban acute care hospitals and smaller rural hospitals that face their own unique challenges. On a transactional level, Underwood has handled mergers and acquisitions of significant hospital groups, including related Federal Trade Commission issues. Going back decades, we have also defended hospitals, physicians, and other providers in alleged malpractice litigation and dispute resolution.

Practice Groups

Practice groups face their own set of challenges. From buy-sell agreements and facility acquisition to insurance, cost recovery and reimbursements, and regulatory compliance, every practice group needs a full service law firm, with a dedicated health care team, at its side. 

Many Underwood lawyers have devoted their entire careers to meeting the needs of these providers.  Our lawyers include the General Counsel to the Texas Health Care Association, members of the American Health Care Association Legal Advisory Committee, and in a litigation context, defense lawyers who are Board Certified in Civil Trial Law and Personal Injury Trial Law by the Texas Board of Legal Specialization.