Re-Establishing a Physician Practice

1
Re-Establishing a Physician Practice

• Reed Tinsley, CPA

2
Causational Events

• Practice Buy-Back (ex. PPMC or Hospital)
• Withdrawing From Group Practice (Either
  Voluntarily or Involuntarily
• Academic Medicine to Private Practice
• Physician Relocation
• Practice Merger
• Others?

3
Issues You Must Address

• Non-Competition Clauses
• Group Practice Buy-Out Provisions
• Financing the Departure
• Preparing a Cash Flow Projection the Right Way!
• How Much to Finance Repurchase/Working Capital
• Do I Have Collateral?

4
Issues You Must Address

• Negotiating a Buy Back
• IRC Section 1060
• Review Tax Impact
• Get the Best Price Possible
• New Provider Numbers
• Federal Identification/State Tax
• Medicare/Medicaid
• http//cms.hhs.gov/providers/enrollment/

5
Issues You Must Address

• Managed Care Credentialing
• Must You Re-Credential?
• Can You Stay on the Plan(s)?
• How Long Will This Take (and its short term
  impact on practice cash flow)
• If No Re-Credentialing, Payer Notification Issues

6
Issues You Must Address

• Where are my Patients Going to Come From?
• Primary Care (Location)
• Specialty Care (Referral Patterns)
• Leadership/Governance
• Setting up a New Physician Compensation System
  (Formula, Stark, Etc.)

7
Issues You Must Address

• New Entity Selection (Corporation ( C vs. S),
  LLC, LLP)
• Setting the Strategic Vision/Plan
• Any Other Important Issues?

8
Timeline

• To Re-Establish the Practice

9
Questions

• Answers