Industry

Physician and Medical Groups

Empowering Medical Groups and Physicians to Thrive in a Complex Landscape

Sheppard provides comprehensive counsel for physicians and medical groups navigating corporate, regulatory and operational challenges in a rapidly evolving healthcare landscape.  

Our lawyers are trusted advisors, delivering responsive, practical guidance across specialties, markets and practice models. 

Guiding Clients Through Growth and Change 

Our national Physician and Medical Group team serves medical groups across the reimbursement spectrum— from value‑based and population health models (shared savings, capitation, global risk) to traditional fee‑for‑service—and across sizes and ownership structures, from small subspecialty practices to large multi‑specialty organizations, independent groups to health system‑affiliated or private equity‑backed entities. 

We also advise consumer‑facing practices (concierge medicine, med spas, fertility, among others) as well as academic medical centers and FQHCs.  

We help clients establish and operate management services organizations (MSOs), ambulatory surgery centers (ASCs), imaging centers, infusion centers, and other complementary businesses—laboratories, urgent care centers, physical therapy/rehab, specialty pharmacy, durable medical equipment, and telehealth—ensuring compliance with fraud and abuse, scope of practice, corporate practice of medicine, licensing, reimbursement, and other regulatory requirements. 

Our lawyers understand the unique pressures facing physicians and medical groups. We provide counsel on employment and compensation models, governance and ownership arrangements, peer review, quality and compliance programs, payor contracting, and reporting obligations. We routinely structure management services organizations and corporate practice of medicine-compliant models across multiple states, to help clients navigate the complex healthcare regulatory environment while achieving their business goals. 

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Areas of Focus

Strategic Transactions
We partner with clients to lead and close healthcare transactions with speed, certainty and a comprehensive understanding of all related business and regulatory issues. Named a Top 10 healthcare M&A firm by Healthcare M&A News in 2025, we have completed more than 120 health plan affiliations, 140 hospital M&A and joint ventures, and dozens of private equity transactions in recent years for clients ranging from regional hospitals and plans to the largest health systems and private investors in the nation.
Healthcare Regulatory and Compliance
Our regulatory work spans the full range of managed care and insurance regulations. We counsel on state and federal oversight, Centers for Medicare & Medicaid Services and state agency interaction, product design, provider and vendor contracting market conduct, coverage determinations, utilization management and claims administration. With deep experience in Medicare Advantage, Medicaid, Part D and the ACA, we help clients navigate regulatory complexities swiftly and confidently. We advise plans on risk adjustment, quality programs, audits, marketing compliance and enforcement matters that require practical judgment and responsiveness. Many of our lawyers previously served in government, allowing us to offer clients insight into how agencies interpret and enforce regulatory requirements.
Healthcare Litigation and Government Enforcement Actions
When the stakes are high, healthcare organizations trust us to protect their interests with bold advocacy and strategic problem-solving. Our team’s decades of courtroom and arbitration experience, combined with deep industry insight, enable us to resolve all types of disputes—from commercial disputes and business torts to regulatory enforcement actions to sensitive employment matters. We relentlessly pursue your goals, delivering creative, practical solutions that safeguard your future.
Healthcare False Claims Act Investigations and Litigation
When government scrutiny intensifies, leading healthcare organizations turn to Sheppard for defense in complex False Claims Act (FCA) litigation. With experience in over 100 FCA matters and a team that includes more than a dozen former Assistant U.S. Attorneys, we deliver innovative strategies and proven results. We routinely secure declinations and favorable outcomes in cases involving kickbacks, upcoding, HCC coding, services not rendered, Stark Law and Medicare Part D fraud. 
Healthcare Real Estate
Sheppard advises health systems, providers and investors on complex healthcare and real estate transactions nationwide. We structure and execute joint ventures, acquisitions, financing (including sale-leasebacks), M&A and developments that navigate Stark, Anti-Kickback, tax and other regulatory constraints. Our integrated healthcare real estate team delivers efficient, compliant and commercially sound solutions that support growth, protect mission and drive long-term value. 
Value-Based and Global Risk Arrangements
Accelerate transformation and capture value while minimizing risk. We are a proven leader regarding value-based arrangements, having completed more downstream global risk projects than any U.S. law firm. With our extensive real-world experience, clients can turn innovation into durable revenue and achieve better population health while minimizing enforcement risk. 
Healthcare Antitrust / Merger Control Regimes
We help complete healthcare deals while minimizing antitrust risk by structuring mergers, joint ventures and provider networks, and securing agency clearance. As part of one of the largest and fastest-growing multisector healthcare practices, our healthcare antitrust team guides clients through Hart-Scott-Rodino filings, second requests, and state healthcare transaction review and merger control processes. We defend investigations and litigation, and counsel on growth-stage strategies across overlapping markets and data integrations. Our team has extensive experience guiding clients and stakeholders through these processes and getting transactions across the finish line as efficiently as possible. 
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Health System–Physician Group Affiliations and Alignment Models
We design, negotiate and implement alignment structures between health systems and physician groups that drive coordinated care while meeting strict regulatory requirements. Our experience spans California medical foundation models under Section 1206(l), integrated delivery systems (IDS), accountable care organizations (ACOs), clinically integrated networks (CINs), physician–hospital organizations (PHOs), co-management and professional services agreement (PSA) models, and service line joint ventures.

Experience

Representative Matters
  • Served as lead counsel to build and operationalize a physician services platform from the ground up, including entity formation, physician compensation, and equity incentive design. After launch, led healthcare regulatory execution for a $2.49 billion sale of a 70% equity interest to a national strategic partner.
  • Led the acquisition of a national urology management services organization to support expansion of physician-owned practices and ambulatory surgery centers. The transaction brought growth capital and operating scale to broaden access to high-value specialty care, strengthen clinical coordination, and support cancer care improvement initiatives—while aligning governance, contracting, and regulatory considerations for efficient integration.
  • Advised on a series of strategic affiliations and management services organization acquisitions totaling $600 million+ across multiple states. These transactions expanded a physician-led oncology platform designed to preserve independent practice while adding the scale needed to support innovation, clinical research, and consistent operating standards—helping practices grow without losing clinical focus or operational control. 
  • Led the sell-side transaction for a scaled gastroenterology management services platform, coordinating corporate structuring, diligence, licensing, and change-of-ownership approvals to keep the deal on track. We also navigated payer and provider contracting, privacy, and compliance requirements to reduce closing risk. From formation through add-on acquisitions, we served as ongoing outside counsel—supporting growth with practical, integrated guidance. 
  • Represented a 500+ physician medical group in its affiliation with a large non-profit health system under California’s 1206(l) medical foundation model, and negotiated the related Professional Services Agreement with an incentive-aligned compensation methodology. Helped create an integrated delivery system structure that supported coordinated care, quality improvement, and operational alignment while navigating corporate practice of medicine, fraud and abuse, and reimbursement considerations.
  • Represented an orthopedic surgery medical group in an ASC joint venture with a non-profit health system to develop two de novo ambulatory surgery centers. Enabled physicians to invest alongside the health system and transition appropriate cases to a lower-cost outpatient setting, expanding capacity, improving patient access and experience, and supporting efficient, high-quality surgical care.
  • Represented a private equity sponsor in the platform acquisition of an orthopedic surgery practice and continued as outside general counsel for operational legal matters and transaction counsel for add-on growth. Helped build one of the longest-tenured integrated orthopedic platforms, expanding from 15 physicians in one state to 140+ physicians across 42 clinics in five states, including support for value-based care initiatives (bundles/risk-sharing), contracting, governance, and regulatory compliance. 
  • Assisted a large medical group in developing and launching a Peer Review and Fair Hearing program and advised on ongoing physician employment, peer review, and medical board/NPDB reporting matters. Established defensible processes that promote patient safety and quality, reduce employment and credentialing risk, and support consistent documentation and compliant reporting in sensitive performance and disciplinary matters.
  • Represented a medical group that over the past decade has grown from a few physicians in one location to over 200 physicians across 70 locations, including 10 affiliated surgery centers. In our role as outside general counsel, we have represented the medical group in practice acquisitions, the formation of surgery center joint ventures, litigation matters, and regulatory filings.
  • Represented a large health system in its acquisition of over 250 surgery centers across 30+ states, including healthcare regulatory due diligence and state and federal regulatory filings.
  • Counseled medical groups—from single-specialty to large multi-specialty organizations—on revamping physician employment agreements and documenting complex compensation models. Improved clarity and consistency across contracting, strengthened compliance with applicable regulatory frameworks, and reduced risk of disputes and employment-related litigation by aligning compensation terms, duties, governance, and termination mechanics with medical group operations.