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Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

Tennessee Medical Association & Bass, Berry & Sims

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Download the Healthcare Fraud & Abuse Review 2017, authored by Bass, Berry & Sims

The Healthcare Fraud & Abuse Review 2017 details all healthcare-related False Claims Act settlements from last year, organized by particular sectors of the healthcare industry. In addition to reviewing all healthcare fraud-related settlements, the Review includes updates on enforcement-related litigation involving the Stark Law and Anti-Kickback Statute, and looks at the continued implications from the government's focus on enforcement efforts involving individual actors in connection with civil and criminal healthcare fraud investigations.

Click here to download the Review.

Event Recap: 2017 Health Care Investors Conference


October 24, 2017

More than 100 healthcare investors and executives gathered in Nashville for the seventh annual Health Care Investors Conference (HCIC), hosted by Bass, Berry & Sims and Deloitte.

Early in the conference, Angela Humphreys, chair of Bass Berry & Sims' Health Care Practice Group, summed up the healthcare investing landscape with the salvo: "It’s a great time to be a seller."

Speakers weighed in on healthcare investing during this time of unabated political uncertainty and intense competition for deals. Specific M&A sectors spotlighted were physician practice management (PPM), digital health and post-acute care. 

Physician Practice Management

Panelists explored facilitating physician engagement and practice growth through a process and post-transaction.

Bret Bowerman of Harbour Point Capital praised one of his portfolio companies – Oak Street Health – for its success in provider procurement. He said the network of primary care centers has created an environment where physicians want to practice medicine – one in which physicians are spending more time with a fewer number of patients and are accountable on quality, patient experience and efficiency. "We're trying to create a model in which physicians can thrive."

Excellere Partners' Justin Unertl spoke about his firm's approach to physician practice investments. "We are deeply committed to a continual investment in people, process and technology, while accelerating a practice's organic and de novo growth initiatives alongside a robust M&A strategy." Unertl also referenced the strength of Excellere's radiologist-driven physician practice, Premier Imaging, where they have structured the partnership such that physicians carry a meaningful voice in all levels of governance within the platform.

Envision Healthcare's Clint Cromwell advocated for a disciplined approach to M&A in the heated physician space. "Lack of physician leadership is the main reason we walk away from a deal."

Digital Health

Panelists agreed that while there is a lot of cool tech in the marketplace, many healthcare providers are not seeing the return on investment because the data isn’t integrated into one system, thereby actionable. Premier Inc.'s Dave Vorhoff said much of his investment is in continuing to try to make data more useable from a clinical perspective. "It's hard to believe that – now in 2017 -- we've spent so many billions on electronic health records but didn’t focus on interoperability."

Devin Carty, COO of Martin Ventures, suggested investors stay mindful of some larger trends that he believes will continue: Hospitals still need revenue growth and profit, patient care should be delivered in the lowest cost setting, with the highest quality and best patient experience, and deductibles are going to continue to increase, motivating consumers to be more involved in healthcare decision making.

On digital health wish lists: Self-insured employers are seeking tools to minimize benefits costs by providing employees with a high performance network of care and completely new models of care, which continue to push care into the home.

Post-Acute Care

Moderator, Leigh Walton of Bass, Berry & Sims, kicked off the panel by identifying some of the value propositions in post-acute care, including: the aging population, increase in prevalence of chronic conditions, high value to cost ratio, technological advances, and patient preference for care at the lowest acuity setting possible.

Diversicare Healthcare Services' Joseph Deans noted the readmission crackdown on hospitals is positioning post-acute players, like Diversicare, as strong partners. 

All agreed that the sector is ripe for technological advances, which could improve efficiencies and patient outcomes. Robert Walker of Apria Healthcare Group said, "The hardest thing for us is to get paid. Today, most of our orders actually come in through fax." His most significant recent transaction was a software play, boosting his company’s administrative prowess. 

Private Equity Q&A

The private equity panel agreed with Humphreys – it's a sellers' market. At the same time, they know they're buyers at heart. Ryan Kelley of Shore Capital Partners observed, "We're selling what we can, but at the end of the day, we're in the business of buying companies." The panelists – and audience – also unanimously agreed that the uncertainty in D.C. is not negatively affecting private equity.

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