Alexandra Busto

Alexandra Busto is an associate in the Healthcare group. She works with academic medical centers, hospitals, long-term care facilities, surgery centers, foundations and clinics, medical groups/IPAs, accountable care organizations, and other entities affiliated with the healthcare industry. Alex also represents companies in the health information, medical device, and telehealth fields.

I focus on transactional and regulatory matters for healthcare providers and others in the industry and, specifically, I assist clients with hospital/physician alignment strategies, joint ventures, mergers, acquisitions, and other strategic transactions. My practice spans across multiple sectors of the industry, including physician group practices, community hospitals, multi-state health systems, ambulatory surgery centers, in-vitro fertilization and reproductive services clinics, telehealth platforms and service providers, management services organizations (MSOs), dental providers, veterinarian clinics, imaging centers, and home health agencies.

I frequently advise on the development and expansion of physician foundations, hospital-based clinics, and teaching/educational clinics, including through physician practice acquisitions and the structuring of complex services agreements or staffing arrangements. In addition, I regularly opine on and structure transactions within the parameters of state prohibitions on the corporate practice of medicine (and other healthcare professions), including via the “friendly” PC-MSO model.

In connection with these transactions, I navigate complex regulatory approval requirements, including representing nonprofit clients in seeking waivers and consents from the California Attorney General.

I also serve as healthcare regulatory counsel to our clients, specifically with respect to federal and state physician self-referral prohibitions, anti-kickback statutes, licensing and certification, and other healthcare compliance matters. With the continued rise of telehealth and focus on capabilities related to remote care and digital health, I work to address challenges of reimbursement, licensing, state law prohibitions, access to and use of data, and fraud and abuse compliance in these areas.

I expect that the continuing development of new technologies will encourage greater collaboration between providers and will have the potential to change the way healthcare organizations deliver care. As federal and state agencies shift their focus to data sharing and coordination and adopt policies promoting digital health technologies, I anticipate seeing increased sophistication in approaches to the provision of accessible, quality care at lower costs.