Nelson Hardiman is a proud strategic partner for industry-leading ambulatory surgery centers (ASCs). We understand the unique challenges facing ASCs, having actively navigated through every phase of an ASC’s life cycle. With surgeons’ services being reimbursed at ever-lower rates by Medicare and insurers, we know it is essential to develop ambulatory surgery centers as successful profits centers essential to the future of the healthcare industry.
Our unique experience serves physicians seeking reimbursement for in-network and out-of-network spaces. Whether you are planning to get into the ASC business or are an existing ASC struggling with compliance or reimbursement issues, Nelson Hardiman provides the strategic counseling and representation to fulfill your business, regulatory or dispute resolution needs.
Our Work Includes:
- Acquisition Advised a non-US buyer with respect to healthcare regulatory issues in a multi-million dollar purchase of stock in nine physician clinics and outpatient surgery centers located in California, Nevada and Florida.
- Arbitration Defended an outpatient surgery center in arbitration with a surgeon alleging deceptive marketing practices in violation of the federal Lanham Act and breach of an exclusive services contract.
- Business Dispute Obtained terminating sanctions and summary dismissal of a complaint filed against a client ambulatory surgery center seeking damages for alleged breach of services contract.
- Class Action Represented out-of-network outpatient surgery centers (ASCs) in federal putative class action against health services businesses and ERISA plans for alleged failure to reimburse ASCs according to a proper methodology for calculating the usual, customary and reasonable (UCR) reimbursement.
- Finance Documented the financing and/or sale of over 25 ambulatory surgery centers.
- Licensure and Certification Advised on licensure, certification and/or related matters for ambulatory surgery centers
- Mergers and Acquisitions Managed due diligence and pre-and post-acquisition notices for venture capital purchase of multiple ambulatory surgery centers and pain clinics.
- Reimbursement Successfully represented an ambulatory surgery center in out-of-network “fee forgiveness” action against a major insurance company. Pursuing more than $3M for claims improperly denied based on claim that surgery center “forgave” patient contribution as inducement for using out-of-network facility.
- Trade Name Dispute Represented ASC in an action against a competing ASC for trade name infringement.