Philip E. Legendy

• Represented managed care organizations responding to audits by the Office of the Inspector General of the US. Department of Health and Human Services (HHS-OIG) and the Centers for Medicare & Medicaid Services (CMS).
• Advised national managed care carrier in connection with post-acquisition review of substantial risk-adjustment data submission issue and subsequent engagement with CMS relating to remediation of same.
• Advised non-profit human services organization on structure and general corporate matters relating to disability care and housing program.
• Represented large radiology group on general corporate matters including hospital affiliations, joint venture proposals, employment matters, and regulatory compliance.

Investigations

• Represented managed care organization responding to inquiry relating to MRA programs, including retrospective and prospective chart review, home-assessment, and other risk-score optimization functions.
• Represented multi-center provider group in responding to investigation by the U.S. Department of Justice (DOJ) into COVID-related Medicaid billing practices.
• Represented home-health agency in internal investigation relating to data breach and theft of trade secrets by competitor.
• Represented multi-state provider group in internal investigation of alleged employee misconduct relating to Medicaid self-directed care program.
• Represented nursing home in investigation by New York Attorney General (NYAG) into staffing, finance, and general compliance issues.

M&A

• Represented MAO in acquisition of multi-state primary care provider group, including negotiation of purchase agreement, regulatory diligence, indemnity, and engagement with regulatory authorities to obtain necessary clearances and approvals.
• Represented private equity acquirer in negotiation, structuring, and regulatory diligence relating to acquisition of multi-center hospice company.
• Represented physician staffing company in sale to private equity acquirer, including drafting of purchase agreement, regulatory diligence, and negotiation of escrow and indemnity coverage.
• Represented MAO in acquisition of 500,000+ member regional health plan, including negotiation of purchase agreement, regulatory diligence and management of forensic data consultant, structuring, and indemnity.
• Represented vision care provider on negotiation, structure, regulatory matters, and sale of all assets to private equity buyer.
• Represented multi-center 340B pharmacy proposed equity sale to strategic acquirer, including preparatory compliance remediation, due diligence, structuring, and negotiation of purchase agreement and other ancillary documents.