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Nossaman LLP


Ambulatory Surgery Centers

Nossaman has extensive experience in representing management companies, physicians and health system clients with all of their transactional and regulatory legal needs involving the ambulatory surgery center (ASC) industry.  This experience covers all aspects of an ASC transaction from the due diligence phase through closing and beyond.  Our ASC attorneys are well versed in advising on various transaction structural issues from a tax, legal and business perspective.  We negotiate and draft all documents surrounding an ASC transaction, including purchase agreements, operating agreements, management agreements and development agreements.  Our attorneys advise on compliance with healthcare laws, including federal and state Anti-kickback Statutes, the Stark Law, antitrust laws, corporate practice of medicine laws, medical staff matters and HIPAA compliance, as well as change of ownership requirements for Medicare and state and local licenses and permits.  We are intimately familiar with three-way joint ventures among physicians, management companies and health systems and the various issues and documents relating to these transactions. 

We help clients to:

  • Syndicate interests in an ASC, including compliance with federal and state securities laws.
  • Navigate through due diligence, including review of real estate leases, equipment leases and physician arrangements to ensure compliance with fraud and abuse and other healthcare laws.
  • Negotiate and draft ASC transaction documents and ancillary business arrangements, including anesthesia contracts, medical directorships and billing and collections agreements.
  • Process change of ownership applications in connection with an ASC transaction, including Medicare certification and other licenses and permits that are being transferred.
  • Negotiate and draft joint venture documents among physicians, management companies and health systems.
  • Handle day-to-day business and legal issues that arise, including buy-in and redemptions of physician ownership, noncompetition restrictions and other partnership issues.
  • Address compliance issues regarding Medicare conditions of participation and defense of decertification actions,
  • Revise Medical Staff bylaws, conduct peer review investigations and prosecute disciplinary hearings.
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