Healthcare private equity

Joshua represents a number of private equity sponsors in their healthcare acquisitions and divestitures, and the on-going representation of their healthcare portfolio companies, having developed a niche in addressing healthcare driven transaction structure issues as well as healthcare regulatory due diligence issues. On the acquisition side, his work has been geared toward leveraged buyouts and has included multiple leveraged buyouts of national and regional ambulatory surgical center companies, multi-site imaging center businesses and home healthcare companies. He has advised private equity clients in their acquisitions and worked closely with their due diligence teams to quickly identify healthcare regulatory issues ranging from healthcare fraud and abuse concerns, Medicare billing issues and federal and state licensure issues.

Ambulatory surgical centers

Joshua represents national and regional ASC management companies, independent ASCs and individual physician investors with all of their transactional, regulatory and litigation needs. His national experience includes ASC transactions in California, Colorado, Florida, Georgia, Idaho, Kansas, Kentucky, Louisiana, Massachusetts, Maryland, Michigan, North Dakota, New Jersey, New York, North Carolina, Texas and other states. His experience includes syndicating startup ASCs, selling and redeeming physician equity interests, squeeze-out mergers, buying and selling equity stakes in ASCs on behalf of, or to, large private-equity funded and publicly traded corporate buyers, revising governing documents and developing business models to facilitate an ASC’s capture of ancillary revenue streams, including diagnostic imaging, anesthesia and pathology services.

Hospitals and health systems

Joshua represents hospitals and health systems in a wide array of healthcare transactional and regulatory matters with a particular focus on developing innovative business models involving hospital/physician joint ventures or contractual arrangements.

Diagnostic imaging and ancillary services

Joshua represents hospitals and health systems, independent diagnostic testing facilities and group practices in connection with their diagnostic imaging transactions and regulatory issues. He has been instrumental in the development and refining of cutting edge business models related to the delivery of such services, including developing quality and efficiency measured productivity arrangements, shared-ancillary arrangements, and ancillary-only management business models that have permitted health systems, group practices and imaging centers to collaborate in the delivery of various diagnostic imaging modalities and ancillary services (such as PET, CT, MRI, ultrasound, greenlight, lithotripsy, radiation therapy, cyber-knife, nuclear camera, clinical lab, pathology, physical therapy and dispensing prescriptions).

Concierge medicine

Joshua was part of the team that developed the healthcare business model for the largest concierge medical practice in the United States. He advises medical practices on transitioning to a concierge practice as well as with the ongoing transactional and regulatory issues of the concierge practice.

Medical groups and physicians

Joshua represents numerous medical groups in all of their transactional and regulatory needs, including the development of super groups to capture ancillary revenues and working with clients to satisfy their physician compensation goals in a manner that is compliant with the Stark Law and other healthcare regulations. Joshua also assists medical groups and physicians with employment agreements, enforceability of non-compete provisions, professional service agreements, administrative service agreements, governing documents and a range of other transactional and regulatory matters.

Urgent care, physician and dental practice management and healthcare consultants

Joshua represents a number of urgent care companies, physician and dental practice management companies and other healthcare provider consulting companies in developing their business models from a transactional and healthcare regulatory perspective. His clients include multiple private equity funded urgent care companies and physician and dental practice management companies in assisting them with all of their healthcare transactional and regulatory matters.

Durable medical equipment

Joshua has substantial experience in the durable medical equipment and incontinence healthcare industry, having represented several clients in all of their transactional and regulatory matters relating to the delivery of home care products vis-à-vis the Internet, agency agreements, marketing initiatives and other matters.

Healthcare regulatory

Joshua has represented clients investigated by various federal and state agencies, including the Centers for Medicare and Medicaid Services, the Department of Health and Human Services Office of Inspector General, the Florida Agency for HealthCare Administration, the Florida Board of Medicine and the Office of the Attorney General of the State of Florida.