Scott R. Simpson

/My focus

Healthcare Transactions

I’ve worked with for-profit and nonprofit companies in connection with the merger, purchase, and sale of healthcare providers and companies, serving as corporate and healthcare regulatory counsel. I’ve assisted in the completion of several multi-jurisdiction transactions, which often pose a wide variety of state and local regulatory challenges. I help our clients efficiently and expeditiously manage the due diligence phase of the deal and draft the various documents that embody the deal, from the letter of intent phase through the closing of the transaction.

Fraud and Abuse and Compliance

A significant focus of my practice involves helping our healthcare clients navigate the thicket that is the federal fraud and abuse laws, including the Stark Law, Anti-Kickback Statute, and the law imposing civil monetary penalties for beneficiary inducement and their state analogs. I am often asked to review a proposed arrangement as part of a healthcare company’s internal compliance efforts to assist in the defense of a qui tam lawsuit or to help craft a response to a government inquiry (as through a subpoena or civil investigative demand). I also support healthcare companies and their compliance professionals with more general compliance investigations and regularly advise on self-disclosure obligations to federal and state agencies and provide assistance in response to government audits.

/Looking ahead

As access to capital has been more difficult in recent years, we have seen more partnerships and joint ventures between large nonprofit health systems and private equity firms or sophisticated healthcare management companies. These arrangements, which include ambulatory surgery center ventures and new service line offerings, can provide health systems with enhanced revenue opportunities, expanded community benefit, and access to new management talent. While these joint ventures can be productive partnerships for both parties, regulators have longstanding compliance concerns with these arrangements. They must be structured appropriately to avoid fraud and abuse and other compliance issues. We think regulators will continue to monitor these transactions closely as to how they impact both the quality and the cost of care.

/Insights

• “Healthcare transactions under scrutiny with New York’s new law,” Bloomberg Law, May 11, 2023 (co-authored with Justin Pfeiffer)
• “Industry-Funded Education for Healthcare Professionals Can Now be a Criminal Matter,” Rochester Business Journal, September 16, 2022
• “The Potential Demise or Reform of the Stark Law in an Era of Value-Based Reimbursement,” AHLA Weekly, March 23, 2018
• “Outsourcing Care: Medical Tourism is the Outsourcing of the American Operating Room,” 238 New York Law Journal 11 (2007) (co-authored with Michele Masucci)
• “Report Card: Grading the Country’s Response to Columbine,” 53 Buffalo Law Review 415 (2005)