Part 4 of 4 — Implementation

Putting the framework, rules, and lessons into a working checklist.

The final step is execution. This closing post pulls the framework (Part 1), the legal rules (Part 2), and the common mistakes (Part 3) into a sequential checklist you can use to move a medical practice acquisition from letter of intent to a successful transition.

Stage 1 — Structure and letter of intent

• Confirm asset vs. equity structure and its tax and liability consequences.
• Form or confirm your CPOM-compliant acquiring entity (and MSO, if investors are involved).
• Sign a letter of intent aligning price, structure, and timeline.

Stage 2 — Diligence

• Review three years of financials, tax returns, and production/collection data.
• Verify licensure, DEA, enrollments, and any Board or payer actions.
• Assess billing/coding practices, litigation history, and HIPAA compliance posture.
• Review the premises lease, equipment, vendor contracts, and payer agreements.

Stage 3 — The definitive agreement

• Negotiate purchase price allocation for tax efficiency.
• Secure seller representations, warranties, and indemnification tied to diligence findings.
• Include appropriately scoped non-compete, non-solicitation, and transition-support provisions.
• Align closing conditions with financing and regulatory approvals.

Stage 4 — Closing and transition

• Begin payer credentialing and re-enrollment early.
• Update licenses, permits, and registrations (DEA, x-ray, business licenses, fictitious business name).
• Handle patient notification and records transfer consistent with HIPAA and California law.
• Onboard staff and providers in compliance with wage-and-hour rules, and update insurance coverage effective at closing.

How West Coast Health Law can help: We guide physician buyers through each stage of a medical practice acquisition — from structuring and diligence through the purchase agreement and post-closing transition.

This series is provided for general informational purposes only and does not constitute legal advice or create an attorney-client relationship. Laws change and every transaction is different; consult a qualified attorney about your specific situation.

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