Management Services Organizations (MSOs)

Nelson Hardiman represents many management service organizations (MSOs) and is known for its depth of experience in establishing MSO-provider relationships. Nelson Hardiman counsels and assists MSOs and providers doing business with MSOs across a wide range of business, regulatory, and strategic challenges, including:

  • Business Transactions
    • Formation of entities and business structure for managed care entities
    • “Captive” relationships
    • MSO relationships with Knox-Keene entities
    • Purchase and sale of managed care entities
    • Network and physician contracts
  • Regulatory Defense
    • DMHC investigations and hearings
    • Medical Board investigations
    • Reimbursement audits and investigations by governmental payors, including Medicare and Medi-Cal
  • Compliance
    • Stark and Anti-Kickback Statute Compliance
    • Medicare and Medi-Cal compliance
    • HIPAA and state patient data privacy and security requirements
  • Litigation
    • False Claims Act/qui tam whistleblower litigation defense
    • Payor and reimbursement disputes
    • Business litigation, including shareholder disputes