In healthcare, some liabilities follow the buyer.
Healthcare deals carry regulatory exposure that can survive the transaction and, in some cases, reach the investors who own the business. Billing practices that look like growth in the model can look like overbilling to a regulator. We test for both.
What the module checks
01
Billing and coding outliers
Statistical outliers in billing and coding patterns compared with peers. These are the same patterns regulators start from.
02
Exclusion and licensure
Providers and staff checked against federal and state exclusion lists, and licensure status in every state of operation.
03
Payer mix and concentration
Dependence on a single payer, program, or reimbursement code, and exposure to announced rate changes.
04
Health-data compliance
HIPAA breach history in the federal breach portal, business associate agreements, and how patient data is handled in practice.
05
Integrations and dependencies
Reliance on EHR vendors and interoperability contracts, and whether those contracts survive a change of control.
06
Clinical and operational claims
Outcomes, volumes, and utilization figures in the CIM, tested against the underlying data.
What it gives your team
An early view of the regulatory exposure behind the revenue, sized well before counsel's final review, with the evidence your healthcare regulatory advisors will need.
Discuss a transaction under LOI.
Share the sector, the deal size, and the end of exclusivity. We respond within one business day with an assessment of fit and the proposed scope of the report.