Healthcare Transactions
Strategic Health Law brings deep industry knowledge and regulatory insight to every transaction. Whether advising on joint ventures, mergers, acquisitions, or strategic investments, we help healthcare organizations navigate complex legal landscapes with clarity and confidence.
We partner with clients to design and implement business arrangements that are both strategically sound and legally compliant. We counsel clients through all phases of a transaction, from strategic planning and regulatory due diligence to contract negotiation and post-closing compliance. We have extensive experience structuring and negotiating agreements with providers, pharmacy benefit managers, administrative vendors, and risk-sharing partners. Our services include:
Strategic Structuring: We help structure transactions to meet business goals while navigating the intricate web of healthcare laws, including the Anti-Kickback Statute, Stark Law, and state-specific requirements.
Regulatory Due Diligence: We conduct thorough legal and compliance reviews to identify risks and opportunities, ensuring clients are well-prepared for regulatory scrutiny.
Transactional Documentation: We draft and negotiate key agreements—such as provider contracts, merger and joint venture documents, and administrative services agreements—with a focus on clarity, enforceability, and compliance.
Regulatory Counsel: We provide actionable guidance on the regulatory implications of each transaction, including CMS rules, managed care requirements, and state insurance department review processes.
Our deep understanding of the healthcare industry allows us to deliver practical, actionable advice that supports both operational success and legal integrity.
Contracts for Health Plans, including Medicare Advantage and Part D Prescription Drug Plans, Medicaid Managed Care Plans, and Qualified Health Plans
Pharmacy Benefit Manager (PBM) agreements
Provider agreements – health system, hospital, physician group, and other providers of ancillary services such as hospice and durable medical equipment
Outsourcing agreements for administrative plan functions such as claims processing, utilization management and appeals, or customer service
Sales channel agreements, including Field Marketing Organizations (FMOs), general agencies, agents and brokers
Behavioral health management, vision benefits administration, dental benefit administration agreements
Risk adjustment services for Medicare Advantage and Qualified Health Plans
We also assist health plans transitioning their provider agreements to value-based payment arrangements, including bundled payments, shared savings arrangements, and capitation arrangements.
Contracts for Healthcare Providers, including Health Systems, Hospitals, Physician Groups, and Other Medical Equipment and Service Providers
Payer contract review and negotiation
Advice, strategy, and contract review for value-based payment arrangements, including upside and downside risk
Advice, strategy, and regulatory analysis relating to entering and exiting payer networks and government health plan requirements
