Alexis Bortniker is a health care transactional lawyer in the San Diego office of Foley & Lardner LLP and is chair of the firm’s health care transaction group. Alexis is a strategic advisor, working with health care providers, payers, private equity companies, and technology companies on joint ventures, mergers and acquisitions, payment structures, and complex business transactions. Alexis has extensive experience in alternative payment models, population health management, risk-based reimbursement systems, and payer/provider alignment. She has significant experience working with providers in Medicare Advantage and CMMI demonstration models. Alexis also advises emerging companies in navigating the move away from direct to consumer payment models to third party payment strategies, including commercial payment, direct to employer, centers of excellence and more.
Alexis also has considerable experience in matters involving fraud and abuse compliance, including self-referral and anti-kickback laws, Medicare and Medicaid reimbursement, self-disclosures and overpayments. This experience allows her to provide full-service transactional guidance to health care entities in their transactions.
Alexis also works regularly with investors, entrepreneurs, and startup businesses in the health care arena, and she advises on a variety of developing legal areas, including risk and outcomes based payment models and joint ventures.
- Alternative Payment Models and Risk Contracting
- Represents multiple investor backed direct contracting entities participating in the CMS Global/Professional Direct Contracting Model in matters related to provider formation and structure, joint ventures, provider participation and CMS compliance.
- Advised health care providers across the health care continuum in negotiations of participation agreements with over 250 insurers and third party payers across the country Advised large nephrology group in a new joint venture with a private equity backed nephrology management services organization in order to transform kidney care through the development of a full risk payment model.
- Represented oncology practices in their affiliation with national oncology MSOs across the country.
- Advised oncology practices nationally on hospital/physician alignment.
- Telemedicine Managed Care Contracting
- Assisted numerous telemedicine companies in managed care contracting strategy and negotiations across all 50 states. The work allows companies to successfully become in-network providers, no longer relying only on direct to consumer model.
- Assisted telemedicine companies in negotiating direct to employer contracts and networks, and other strategies for coverage and payment.
- Telebehavioural Health
- Assisted numerous tele-behavioral health companies in structural compliance, payer contracting strategies, and care compliance guidance to build national platform for delivery of adult and pediatric tele-behavioral health.
- PACE Programs
- Advised not-for-profit PACE Program in a sale to a for-profit company, advising on regulatory and corporate compliance issues, resulting in a for-profit PACE program fully capitalized and position to expand the program to seniors in multiple states.
- Technology Mergers & Acquisitions
- Advised digital health and artificial intelligence company in the acquisition of a provider group in order to expand its clinical product offering. Advised on corporate practice of medicine, risk bearing provider, and other regulatory issues involved in acquisition of a clinical provider.
- The Best Lawyers in America© in the field of Health Care Law (2018-2022)
- Massachusetts Super Lawyers® – Rising Stars lists (2014 – 2016), which recognizes the top 2.5% of Massachusetts lawyers under 40
- American Health Lawyers Association
- California Society for Health Care Attorneys.
- JD, Duke University School of Law (2007)
Notes Editor, Duke Journal of Comparative and International Law
- BA, Harvard University, cum laude (2004)