Outpatient and Ambulatory Services

The first ambulatory surgery center (ASC) opened in 1970, and today there are approximately 12,000 ASCs across the country. In fact, ASCs now outnumber hospitals in California, Georgia, Florida, Texas and a number of other states.

Our attorneys have been at the forefront of the outpatient services sector since the early 1980s, and clients value Holland & Knight's institutional depth and industry knowledge given the complexities in healthcare regulations and deal structure. Today, as more care shifts to the outpatient setting, many of the largest providers, as well as smaller providers operating on local or regional levels, look to Holland & Knight's Outpatient and Ambulatory Services Team for skilled counsel on transactional, regulatory and litigation matters.

The Full Spectrum of Outpatient Services

In addition to Holland & Knight's extensive experience with ASCs, our healthcare attorneys represent clients across a wide range of outpatient services, including:

• urgent care centers
• diagnostic imaging facilities
• oncology and cancer treatment centers
• dialysis clinics
• laboratories
• infusion therapy centers
• free-standing emergency departments

Transactional Matters

Representing some of the largest ambulatory surgery networks in the United States, our lawyers routinely provide counsel on a variety of transactions and facility development matters, including mergers and acquisitions (M&A) and divestitures. Our attorneys have completed hundreds of joint ventures and syndications with physician investors, physician groups, hospitals and health systems across the United States. Additionally, we assist ASCs and other outpatient providers with corporate finance matters, including public and private offerings of equity and debt, credit facilities and equipment leasing arrangements involving banks, commercial finance companies, private equity funds and venture capital firms. We help with the development of startup companies and de novo facilities, including organization, capitalization and governance. Our lawyers also provide counsel on real estate and facility leasing matters related to transactional matters and day-to-day operations.

Operations and Regulatory Compliance

Holland & Knight attorneys provide day-to-day assistance with facility-level legal and operational issues, including state and federal regulatory and licensure matters, accreditation and survey issues, physician licensing and credentialing, and Certificate of Need applications and opposition. We also assist ASCs with matters related to the interpretation, enforcement and amendment of partnership and operating agreements, as well as the evaluation and defense of fair market value (FMV) compensation.

Litigation and Government Investigations

Outpatient services providers rely on Holland & Knight's litigation experience to resolve complex commercial disputes. We also advise clients in connection with government and internal investigations, qui tam/whistleblower actions and False Claims Act defense, Medicare audits and appeals, peer review, medical staff issues, employment matters and representation before federal and state government agencies and regulators.