Leonard Lipsky

Partner
LANGUAGES
Russian
LINKEDIN
Leonard Lipsky

Overview

Leonard Lipsky provides strategic and practical guidance to healthcare providers, population health management companies and investors navigating the rapidly evolving healthcare industry.

Healthcare Transactions

Leonard advises healthcare providers and C-Suite executives on planning, structuring and negotiating complex healthcare transactions, including mergers, acquisitions, sales, joint ventures and strategic partnerships. His experience spans physician practices, health systems, IPAs, ACOs, CINs, MSOs, care coordination and population health management companies, ambulatory surgery centers (ASCs), hospitals, long-term care facilities, and venture capital and private equity investors. Leonard counsels for-profit and not-for-profit boards on strategy, governance, risk management and fiduciary duties. He also provides guidance on partnership, shareholder and operating agreements, as well as resolving business disputes among investors and management.

Global Risk and Value-Based Care Contracting

Leonard offers sophisticated strategies for forming global risk-bearing entities and clinically integrated networks (CINs) and advises on innovative risk-sharing payment models, including ACOs, MSOs and IPAs. He helps healthcare providers transition from traditional fee-for-service (FFS) reimbursement models to value-based and global risk models, such as shared savings, total cost of care and full capitation arrangements. Leonard also advises on utilization review, claims payment delegation and credentialing to support payor-provider alignment and improve quality and economics.

Regulatory Compliance and Risk Mitigation

Leonard counsels investors and healthcare businesses on compliance with the corporate practice of medicine (CPOM) laws and provides regulatory guidance on the Stark Law, the Anti-Kickback Statute, fee-splitting and licensing. He regularly supports healthcare transactions with regulatory due diligence and develops remediation strategies for noncompliant or high-risk activities.

A frequent speaker and author on legal issues in the healthcare industry, Leonard keeps clients informed on industry trends, including population health management, payor-provider alignment and the shift to value-based care.

In his free time, Leonard enjoys spending time with his family, reading and playing golf.


Experience

Recent Representations

Leonard provided advice to:

  • A leading technology-enabled provider group for home care in its acquisition of physician practices on the East Coast.
  • A large physician practice in the New York City market in its acquisition of multiple physician practices, the formation of a de novo ambulatory surgery center, and various corporate and regulatory matters.
  • A health system in its strategic partnership with a national health plan to enhance value-based care and expand healthcare access for Medicare Advantage beneficiaries throughout the health system’s network.
  • Multiple IPAs in the Northeast in the structuring, negotiation and execution of all their value-based and risk contracting arrangements with major health plans operating in their respective markets.
  • UAW Retiree Medical Benefits Trust, one of the largest non-governmental purchasers of retiree healthcare in the United States, in its negotiation with United Healthcare Insurance Company of a Medicare Advantage Prescription Drug Plan (known as an Employer Group Waiver Plan) to provide group health benefits across the United States to retired members of the United Auto Workers labor union and their dependents.
  • CAIPA MSO, LLC, a New York-based management services organization affiliated with Chinese American IPA, Inc. d/b/a Coalition of Asian-American IPA (CAIPA), a leading independent practice association serving the greater New York City area, in connection with its strategic alliance with and investment by Apollo Medical Holdings, Inc. (ApolloMed) (NASDAQ: AMEH) in CAIPA MSO.
  • An IPA in the sale of its Medicare Advantage line of business.
  • A long term care system in its acquisition of a financially distressed skilled nursing facility.
  • Private equity firms investing in dental practice management companies that supply services to dental practices on the East Coast.
  • A private equity firm investing in the veterinary medicine space throughout the United States.
  • Private equity firms investing in home care and home health services agencies.
  • Barnabas Health, a New Jersey hospital system in connection with its merger with Robert Wood Johnson, creating New Jersey’s largest health care system—and one of the largest in the nation—now known as “RWJ Barnabas Health.”
  • The MemorialCare Health System in the formation of a first-of-its-kind direct-to-employer ACO to serve the health care needs of employees (and their dependents) of The Boeing Company in Southern California.
  • A hospital system on structuring a new care coordination program at the hospital in a manner that complies with regulatory requirements and meets business needs.
  • A hospital system in its acquisition of two health care systems in the northeastern United States.
  • The merger of two not-for-profit organizations that serve individuals with intellectual and developmental disabilities (IDD).

* Includes some matters prior to joining Sheppard Mullin

Credentials
Education

J.D., St. John's University School of Law, 2008

B.A., New York University, 2005, cum laude

Admissions

New Jersey

New York

U.S. District Court, District of New Jersey

Memberships

American Health Lawyers Association

New York State Bar Association