代表的な経験

• Counsel to HeartPlace, P.A., the largest physician owned cardiology practice in Texas, in connection with its recapitalization by US Heart & Vascular, an Ares Capital company.
• Acted as lead counsel in the sale of Houston-based Invicta Health Solutions, LLC, a provider of healthcare revenue cycle management solutions, to RSi, LLC.
• Counsel to Orthopaedic Institute of Dayton in its recapitalization by Orthopaedic Associates and Revelstoke Capital Partners, LLC.
• 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 University of Florida and UF Health Corporation in the acquisition of the Florida operations of The Scripps Research Institute.
• Counsel to a middle-market private equity sponsor in the recapitalization of a Medicaid-reimbursed non-medical home health agency opening in Louisiana and Mississippi.
• Counsel to a middle-market private equity sponsor in the development of a de novo pediatric telemedicine platform in Virginia.
• 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 payor 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, payor 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 laws, including EKRA.* This work involved working with business and legal teams on staffing, marketing, and partnership arrangements and structures.

*フォーリー入社前の担当案件。