Peter Egan represents health care industry clients in complex business transactions and with compliance and regulatory analysis. He also leads the firm’s behavioral health team.
What do you focus on?
I help health care and life sciences companies structure transactions to comply with federal and state fraud and abuse laws and regulatory issues. I also regularly advise health care management companies and their provider clients on whether proposed services and compensation methodologies are permissible under state law.
The behavioral health field is in a state of unprecedented transformation, as integrated care models are becoming a priority across the country. I lead the firm’s behavioral health team, bringing cross-disciplinary skills to solve regulatory, M&A, investment and supportive housing issues for our clients.
With considerable experience representing hospitals and medical centers on all types of corporate and regulatory matters, I provide strategic advice on practice acquisitions and physician alignment issues. My experience with faculty practice plans, “captive” practices and compensation pooling arrangements helps clients understand all available options.
Clients turn to my team for compliance counseling advice. My work in this area includes investigating potential fraud and abuse matters, making disclosures to the United States Attorney’s Office to preempt whistleblower claims, and preparing self-disclosures under the Stark Law.
My M&A experience also includes whole hospital mergers and affiliations, private equity transactions, and the purchase and sale of licensed facilities such as nursing homes and ambulatory surgery centers.
What do you see on the horizon?
The focus on best practices and protocols will continue, with an emphasis on mental health and substance abuse treatment. Separately, industry participants are improving their use of IT systems to drive clinical integration, quality improvement and better financial performance. We are assisting clients with strategic decisions and legal structures to take advantage of this information revolution.
Publications and Presentations
- “Healthcare Fraud and Abuse Update 2017 and Related Criminal Defense Issues”, New York State Society of CPA’s Forensic Accounting and Litigation Services Conference, New York, New York, May 22, 2018 (Presenter)
- “Not-for-profit mergers and acquisitions: What your organization needs to know”, Interagency Council of Developmental Disability Agencies (IAC), March 6, 2018 (Presenter)
- “What New York Not-For-Profit Providers Should Be Thinking About When Considering a Merger or Affiliation”, Cohn Reznick offices, New York, New York, June 1, 2017 (Presenter)
- “How to Respond to a Government Investigation,” Health Care Compliance Forum, Nixon Peabody LLP, New York, New York, February 28, 2017 (Presenter)
- “OMIG's 2016–2017 Work Plan and Compliance Initiatives in the Year Ahead,” Health Care Compliance Forum, Nixon Peabody LLP, New York, New York, June 2, 2016 (Presenter)
- “Internal Investigations: Shining the Spotlight on the Role of the Attorney-Client Privilege,” Health Care Compliance Forum, Nixon Peabody LLP, New York, New York, March 24, 2015 (Moderator)
- “Self-Disclosing Medicare and Medicaid Overpayments,” Health Care Compliance Forum, Nixon Peabody LLP, New York, New York, October 7, 2014 (Moderator)
- “A Legal Update,” Cerini & Associates, LLP’s Non Profit Update 2014, June 24, 2014 (Presenter)
- “Meeting the Challenges of Provider Reimbursement: New Payment Models, Implications, and Opportunities,” Connecticut Healthcare Financial Management Association, November 2013 (Presenter)
- “Cuomo’s Executive Order: The Final Shake-Out,” Health & Welfare Council of Long Island, September 11, 2013 (Presenter)
- “Valuation Issues When Selling to Private Equity or Medical Centers,” Adelphi University, November 2012 (Presenter)
- “Employment Pitfalls in Light of Practice Acquisitions,” New York State Radiological Society, October 2012 (Presenter)
- “Not-for-Profit Board Duties in the Era of Health Care Reform,” Health Care Check-up Webinar Series, Nixon Peabody, February 2012 (Co-Presenter)
- “Preparing to Sell Your Business: Now is the Time,” Hot Topics for Middle Market Companies Discussion Series, Nixon Peabody, January 2012 (Panelist)
- “Health Care Fraud & Abuse for Acute Care Providers,” Foundation for Accounting Education’s Healthcare Conference, September 2011 (Presenter)
- “How the Changing Healthcare Environment Affects You and Your Clients,” Nassau County Bar Association, May 2011 (Presenter)
- “Accountable Care Organizations: What you need to know,” Nixon Peabody Webinar, April 21, 2011 (Presenter)
- “Overcoming Legal Obstacles to Implementation of Accountable Care Organizations,” National Forum on Clinical Integration, November 2010 (Presenter)
- “Update on Tax Issues Affecting Not-For-Profits,” SUNY Old Westbury Fiscal Conference, October 2010 (Presenter)
- “Health Care Reform & Its Impact on Your Bottom Line,” The Knowledge Group LLC Webinar, September 2010 (Presenter)
- “Independent Contractor or Employee? Higher Stakes for Many Medical Practices,” Journal of the American College of Radiology, September 2010 (Co-author)
- Representation of a large behavioral health care IPA in contract negotiations with an Innovator ACO
- Representation of a Care Coordination Organization/Health Home for people with intellectual and developmental disabilities (this is a new model for coordinating community-based services with medical and mental health services)
- Representation of large NYC social services agency merging with a developmental disabilities provider
- Representation of developmental disabilities service provider in supportive housing project
- Represented a for-profit health care company in restructuring approximately $555 million of secured and unsecured debt, including the sale of one facility and a new equity investment
- Representation of for-profit substance abuse treatment provider entering New York State
- Prepared co-management agreement between an academic medical center and its employed and voluntary orthopedic surgeons to manage the medical center’s ambulatory surgery center
- Representation of federally qualified health center in its acquisition of a mental health clinic
- Representation of large developmental disabilities provider in negotiations with for-profit pharmacy
- Representation of NYC social services organization in OMIG audit and repayment negotiations
- Represented a health system in the $35 million sale of two nursing homes
- Represented a university’s medical school in the sale of a clinic to a California municipality, to be operated as a Federally Qualified Health Center
- Represented an academic hospital in a transaction with a for-profit medical school to finance a multimillion dollar refurbishment of a medical education center
- Assisted a for-profit telemedicine provider with respect to structuring various services, in light of applicable fraud and abuse laws
- Represented a nationwide franchisor with respect to opening medical locations and operational issues, in light of corporate practice of medicine rules
- Represented a 600+ physician practice in its affiliation with a world renowned cancer treatment center and the development and construction of a new cancer treatment facility on the practice’s campus
- Represented a large developmental disabilities provider in its merger with an entity providing mental health and substance abuse services
- Represented a consortium of social service organizations to provide HCBS waiver services
- Represented a large academic medical center in the acquisition of multiple cardiology practices, including an out-of-state practice
- Representation of a mental health provider merging with a substance abuse and supportive housing organization
- Represented a large social services organization in its merger discussions with a substance-abuse provider that also provided affordable housing
- Represented a large developmental disabilities provider in creating a “captive” practice to provide article 16 services at offsite locations
- Represented the surviving entity in the consolidation of two mental health providers and an affordable housing organization
- Represented a for-profit health care company in the sale and issuance of $11 million in preferred stock, in connection with the restructuring of project financing for multiple centers