James Saling joined Waller in 2017 with nearly a decade of experience advising hospitals, health systems, academic medical centers, outpatient services providers and other healthcare entities in transactional and regulatory matters. Known for his steadiness under pressure, James focuses on overcoming potential compliance or commercial obstacles to close deals that help clients achieve their strategic objectives. Whether he is negotiating joint ventures between healthcare providers, developing integrated delivery systems, or structuring incentive compensation and risk-sharing arrangements, his transactional acumen is complemented by his experience with federal and state healthcare laws and regulations. Clients value his ability to structure financial arrangements and transactions in compliance with the Anti-Kickback Statute and the Stark Law as well as his insight into Medicare certification and reimbursement; state licensure regulations; and corporate practice of medicine and dentistry issues.
James has devoted much of his practice to physician practice acquisitions and integration, hospital-physician affiliations and joint ventures, including those with ambulatory surgery, imaging and cancer centers, independent diagnostic testing facilities (IDTFs), and block lease and clinical co-management arrangements, and under-arrangement relationships. This experience includes the development of hospital outpatient departments and free-standing facilities, the acquisition of existing facilities, counseling clients in developing new service lines, strategic planning and governance issues, and restructuring facility operations for compliance reasons.
Additionally, James has represented multi-billion dollar private equity firms in the investment in and acquisition of various healthcare and specialty providers nationally. He works closely with private equity and venture capital firms and their due diligence teams to quickly identify healthcare regulatory issues, especially with regard to investments in physician and dental practice management companies.
Hospital system clients – investor-owned and tax-exempt – rely on James’ experience with strategic expansion and restructuring including syndications, acquisitions and mergers. As a response to healthcare reform and continued market consolidation, he has assisted clients in a number of innovative affiliation transactions such as the representation of insurance companies in physician practice acquisitions.