Private Equity in Physician Practices: Compliance Considerations

Kelly Koeninger presented at the American Health Law Association's Fraud and Compliance Forum 2021.

Private equity involvement in the health care sector has continued to grow, and physician practices in diverse subspecialties are experiencing the benefits and complications of alliances with PE. With PE-backed health care companies continuing to see scrutiny from federal and state regulators for failure to appropriately comply with health care regulatory laws, it is important for PE firms and their partners to understand the complex regulatory environment they operate in and to structure arrangements to ensure compliance. Koeninger and her co-presenter led a session for in-house and outside counsel and compliance officers. The session discussed:

• Recent settlements entered into by private-equity backed companies.
• Key points of enforcement focus in settlements.
• Various structures utilized by private equity firms when investing in physician practices.
• How health care fraud and abuse laws intersect with structuring private equity partnerships, with a particular focus on key areas of enforcement focus.
• Valuation concerns, and ways in which these agreements can be structured within fair market value.
• How to structure compliant arrangements, with case studies.
• Case studies based on real life experience with an illustration of types of arrangements and fair market value checklist.