Physicians challenged by the changing reimbursement and regulatory landscape rely on Leech Tishman Nelson Hardiman to navigate options for complex healthcare plans that form the basis of Independent Physician Associations (IPAs). We negotiate healthcare plan agreements that deliver seamless solutions for IPA members handling administrative burdens.
Our healthcare attorneys blend healthcare management skills with expertise regarding payor compliance issues to advise IPA physicians on effective healthcare plan options. We work with clients to identify plans and processes that are advantageous to their business structures, including nonprofit entities, limited liability companies, corporations, or other types of shareholder-owned entities. We also assist business structures that allow members to care for patients outside of contracted healthcare plans.
Our firm delivers extensive experience and significant understanding of the healthcare legal landscape to our IPA clients, ultimately providing an avenue for IPA physician members to preserve capital and share risk, maintain independent practices, and participate in coordinated care to improve patient outcomes.
- Negotiated the purchase and sale of an IPA offering forward-thinking care delivery and payment models to an equity investor based on the market potential for value-based care
- Represented an IPA client in complex disputes regarding exclusive provider contracts, transactional misrepresentations, and shareholder disputes
- Advised an IPA client in Palm Springs, CA regarding the Knox-Keene Act and Department of Managed Health Care (DMHC) solvency requirements for risk-bearing organizations
- Defended an IPA client in False Claim Act / qui tam whistle-blower litigation regarding alleged claims violations involving the IPA’s healthcare plans
- Formed several new IPAs, merged physician practices, negotiated new contracts with Medicare Advantage plans, and counseled clients regarding the business and regulatory aspects of IPA operations
- Represented numerous IPA clients in reimbursement audits and investigations by governmental payors, including Medicare and Medi-Cal
- Counseled a primary care IPA client regarding Stark and Anti-Kickback compliance and utilization review requirements in connection with a proposed new healthcare plan structure