Kinal Mahesh Patel is a senior counsel health care attorney with Foley & Lardner LLP based in the firm’s Houston office. As a member of the firm’s Health Care Practice Group, Kinal advises health care, life sciences and insurance companies of all sizes as they navigate regulatory reforms and industry trends. Kinal’s practice combines both regulatory and transactional activities.
Kinal provides transactional counsel to health care providers, plans and other companies on mergers and acquisitions, joint ventures and strategic alliances in the health care and related industries. He has experience with hospital, provider, pharmacy and health plan acquisitions, and implementing strategic alliances and other relationships. He’s supported the implementation of partnerships among health care companies and physician and non-physician provider alignment strategies.
Alternative Payment Models and Risk Contracting
Kinal assists clients to develop alternative payment methodologies and structure shared-risk arrangements, in compliance with federal and state fraud and abuse laws and insurance laws. He supports clients on a variety of payment and service delivery models from CMMI and CMS, including BPCI-A, PCF, DCE and GPDC, and other non-governmental risk adjustment models.
Kinal provides regulatory compliance counsel on regulatory, compliance, licensing, and managed care arrangements. He has advising clients facing pending and suspected compliance issues and government enforcement actions, government payor program enrollment and participation requirements, and licensing and accrediting support. He also has experience handling pharmacy regulatory matters.
Before joining Foley, Kinal was a senior associate at a full-service global law firm in Ohio. Previously, Kinal was a legal fellow and staff attorney with a nonprofit multi-hospital system in Texas where he worked with corporate and clinical leadership in a range of matters such as system integration efforts, policy and procedure development, and physician contracting including medical directorships and employment and recruitment agreements.
- Acted as lead counsel in the sale of Medical Imaging Services, LLC, a company engaged in the distribution, sale and service of diagnostic imaging equipment, supplies and parts to 626 Imaging, a Peak Rock Capital portfolio company.
- Advised an entrepreneurial vascular specialist physician selling physician offices and ambulatory surgery centers and licensing intellectual property to a publicly traded health care organization expanding to a new territory.
- Advised on and negotiated an affiliation arrangement between a specialty physician group and a local health system, which initially led to the development of a new cancer center with shared operations. The work enabled the specialty physician group to maintain its independence and meet its growth targets, strengthen its ties with community providers and facilities, and establish the framework to support future strategic opportunities.
- Advised a large primary care physician group with a partial recapitalization by a private equity investor and counseled on an establishing a risk-bearing entity structure for limited payor lines. The work involved advice on retaining physician control and ownership, creating alternative profits opportunities in the investor, and establishing an insurance intermediary.
- Advised a medical marijuana cultivator, processor and dispenser combination with a similar enterprise operating in different states with stronger fundraising capabilities. The work involved the transfer of current and future business opportunities under state license applications and provisional licenses.
- Advised a DME manufacturer and supplier on private equity recapitalization; a urology group on a sale to a private equity platform; several behavioral health provider practices sale to a private equity platform; a large provider platform’s acquisition of a behavioral health provider practice; and a private fund’s sale of a pet insurance business to a national insurer.
- Advised providers and non-providers participating in the Medicare Shared Savings Program and other CMMI payment and service delivery models. This work has involved supporting a participant provider appeal shared savings determinations following a regional rate adjustment that was not reflected in the historical benchmark.
- Assisted several ACOs and CINs on governance, financial arrangements, membership and managed care payer contracting with risk adjustment and shared savings models.
- Advised a national insurer and PBM and provider-affiliated health plans on Medicare Advantage and Part D compliance, payer disputes, and Medicaid managed care procurements.
- Advised a new insurtech firm piloting a managed care product on startup health insurance operations, network development, and population health tools. The work involved supporting insurance and provider relations teams develop the documentation, processes and tools to build a network and manage risk while integrating digital innovations and a provider-friendly culture into the traditional provider-insurer relationship.
- Advised a national insurer on network development for a new pet insurance line. The work involved developing and negotiating network veterinary clinic arrangements and a corresponding PBM arrangement.
- Advised hospitals and other providers on billing compliance, licensure and fraud waste and abuse laws.
- Advised nationwide substance abuse centers and laboratories on compliance with federal and state fraud and abuse law, including EKRA. This work involved working with business and legal teams on staffing, marketing and partnership arrangements and structures.
*The above list of representative matters and experience was completed prior to starting at Foley & Lardner.
- Adjunct professor, Moritz College of Law, The Ohio State University
- Vice-chair, American Health Law Association, Transactions Affinity Group
- President and board member, Asian Pacific American Bar Association of Central Ohio
- Secretary, Houston Latino Film Festival
- University of Virginia School of Law (J.D., 2012)
- Editorial board member, Virginia Journal of Law and Technology
- University of Houston (B.A., summa cum laude, 2008)