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Ambulatory Surgery Center Transactions

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Our Ambulatory Surgery Center (ASC) Transactions Team combines deep industry knowledge with practical, business-focused solutions derived from experience with many dozens of ASC transactions across the country.

Overview


Our Ambulatory Surgery Center (ASC) Transactions Team combines deep industry knowledge with practical, business-focused solutions derived from experience with many dozens of ASC transactions across the country. We deliver tailored business-oriented strategies that align with each ASC's objectives and market dynamics.

Our Experience in ASC Transactions

Baker Donelson has extensive experience advising ASCs of all sizes nationwide on a vast array of strategic transactions to position them for success, including:

  • Sales, divestitures, and consolidations with national management companies, investors, and private equity-backed platforms
  • Acquisitions of ASCs by buyers of all sizes, including large ASC networks and chains
  • Mergers and consolidations with hospital systems and joint venture partners
  • Syndication with physicians and other investors
  • ASC and office-based labs (OBL) development/formation among physicians in different specialties (and investors)

Regulatory Compliance

Our team has decades of experience navigating the complex regulatory requirements that affect ASCs and play a critical role in due diligence for these transactions. Our attorneys provide guidance on:

  • Anti-Kickback Statute compliance and similar state laws, including financial relationship structuring, referral arrangements, ASC safe harbor provisions, and compliant buy-ins and redemptions
  • Certificate of need and licensing regulations for each state
  • Accreditation and survey issues
  • Medicare and Medicaid regulations, including billing, documentation, provider enrollment, change of ownership, and reimbursement requirements
  • State health care transaction review laws, which can elongate the sign-to-close period and introduce regulatory risk into the dealmaking process
  • HIPAA compliance, including business associate agreements, cybersecurity policies, and breach notification requirements
  • Federal and state employment and benefits laws, including overtime laws, family leave laws, anti-discrimination laws (disability/Americans with Disabilities Act, racial, age, gender, etc.), and ERISA/benefit plan compliance
  • Orthopedics

  • "How to 'Extricate' from a Hospital PSA or Employment Agreement that is Not 'Working Out' to Participate in a Strategic Transaction," 2025 Physician Transactions Conference: Orthopedic & Spine, The Future of Healthcare Conference Series® (March 2025)
  • "Keynote Panel: 'Life After Closing' of a Partnership Transaction from the Perspective of Orthopedic Surgeons Who Pursued Different Strategic Options," 2025 Physician Transactions Conference: Orthopedic & Spine, The Future of Healthcare Conference Series® (March 2025)
  • "Private Equity Partnerships with Physicians in Hospital Relationships – Navigating the Waters," MedAxiom, an American College of Cardiology Company (July 2024)
  • "Optimizing Your Program's Value: Pre- and Post-Transaction Strategies," CV Transforum Spring 2024 Conference (April 2024)
  • "Returns, Risks, and Rewards: Structuring Strategic Transactions for ASCs and Surgery Groups," 29th Annual Becker's ASCS Conference (October 2023)
  • "Strategic Transactions for Spine, Orthopedic, and Pain Management Groups," Spine, Orthopedic + Pain Management-Driven ASC Conference (June 2023)

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