The firm has a deep level of experience representing IPAs from cradle to grave, including advising them on initial formation and structural issues and ongoing operational considerations, such as licensure, financing, business transactions, negotiation of health plan arrangements, and regulatory compliance issues. Some recent examples of our work with IPAs include:
- Advised dozens of clients in forming IPAs to become operational, including preparing articles of incorporation, bylaws, provider participation agreements, forms of payor contracts, risk pool and risk sharing agreements, and policies and procedures.
- Represented a Southern California IPA in negotiating and documenting the development of its ACO arrangement with a regional health system.
- Advised capitated IPAs, messenger IPAs, specialty IPAs, and others on strategic issues, payor negotiations, antitrust risk, credentialing and peer review, anti-kickback, physician self-referral, health plan licensure issues, risk-bearing entity issues, and doctrine prohibiting the corporate practice of medicine.
- Analyzed state law licensing requirements applicable to risk-bearing entities in approximately twenty states.
- Established a hospital risk pool, including drafting and negotiating relevant agreements.
- Served as lead California healthcare regulatory counsel to a large California IPA in transactions with a publicly traded health management company. The transactions included a half-billion dollar financing, a stock acquisition, and a network administrative services arrangement.
- Represented a central California IPA throughout its long term existence, including its sale to a hospital system and its subsequent wind-down and dissolution.