Alexandra Busto

My focus

Healthcare Transactions

I focus on transactional and regulatory matters for healthcare providers and others in the industry and, specifically, I assist clients with hospital/physician alignment strategies, joint ventures, mergers, acquisitions, and other strategic transactions. My practice spans across multiple sectors of the industry, including physician group practices, community hospitals, multi-state health systems, ambulatory surgery centers, in-vitro fertilization and reproductive services clinics, telehealth platforms and service providers, management services organizations (MSOs), dental providers, veterinarian clinics, imaging centers, and home health agencies.

I frequently advise on the development and expansion of physician foundations, hospital-based clinics, and teaching/educational clinics, including through physician practice acquisitions and the structuring of complex services agreements or staffing arrangements. In addition, I regularly opine on and structure transactions within the parameters of state prohibitions on the corporate practice of medicine (and other healthcare professions), including via the “friendly” PC-MSO model.

In connection with these transactions, I navigate complex regulatory approval requirements, including representing nonprofit clients in seeking waivers and consents from the California Attorney General.

Regulatory Compliance

I also serve as healthcare regulatory counsel to our clients, specifically with respect to federal and state physician self-referral prohibitions, anti-kickback statutes, licensing and certification, and other healthcare compliance matters. With the continued rise of telehealth and focus on capabilities related to remote care and digital health, I work to address challenges of reimbursement, licensing, state law prohibitions, access to and use of data, and fraud and abuse compliance in these areas.

Looking ahead

I expect that the continuing development of new technologies will encourage greater collaboration between providers and will have the potential to change the way healthcare organizations deliver care. As federal and state agencies shift their focus to data sharing and coordination and adopt policies promoting digital health technologies, I anticipate seeing increased sophistication in approaches to the provision of accessible, quality care at lower costs.

Insights

• Speaker, “Insider's Views: Ensuring Telehealth Program Integrity,” ATA2023 Annual Conference & Expo, March 5, 2023
• Speaker, “2023 Healthcare Market Trends & Implications,” Nixon Peabody 2023 California MCLE Virtual Seminar, January 20, 2023
• Speaker, “Staying Competitive in the Market: Exploring Innovative Solutions to Physician Alignment Models” Zephyr Healthcare Advisors 2022 Healthcare Leadership & Executive Conference, Las Vagas, NV, September 29, 2022
• Co-Author, “Key considerations for telehealth providers following the Dobbs decision,” Association of Corporate Counsel, August 25, 2022
• Speaker, “Distribution & Market Access Innovation,” Women's Health Innovation Series Reproductive Health Innovation Summit, Boston, MA, February 16, 2022
• Speaker, “Telehealth Trends: Risks, Rewards and Reimbursement,” Health Care Compliance Association, Webinar, March 23, 2020
• Speaker, “Telehealth Trends: Risks, Rewards and Reimbursement,” Nixon Peabody Webinar, November 14, 2019
• Speaker, “Digital Health in IP and Health Care—How Will Highly Regulated Industries Deploy Innovative Technologies?,” Nixon Peabody MCLE Marathon, Los Angeles, January 2019
• Speaker, “Regulatory Basics for Healthcare and Biotech Entrepreneurs,” LA BioStart Legal Basics Program, Los Angeles, August 2018
• Speaker, “The Times, Are They A-Changing? Considerations for Buyers in Traditional and Contemporary Deals,” Nixon Peabody Annual MCLE Seminar, Los Angeles, January 2018