In this article, I state the fundamental negotiating points in an enterprise agreement for an ambulatory operations centre (CSA). I focus mainly on control and output (buy-sell). The CSA`s purchase price was determined: the Relateur stated that the purchase price, based on a multiple of the Centre`s EBITDA (eight times more than the centre`s 2006 result) and not on the asset, was actually a payment for transfers made by surgeons at the centre. Sale of the operations center or merger ⇒ The minority wants some control over its final exit, including to prevent the majority from selling the operating center in a beloved agreement that benefits the majority in the first place. Schaff says that when it comes to a non-competition clause, it is a key reason because doctors and management companies want to make sure that physician owners are not interested in a competitor. Physicians may be concerned that a management partner may not run a competing centre, which could have an impact on the management of the centre. If the lessor and/or its related companies own or control other properties located in the immediate vicinity of the rental premises, the tenant may also wish for a radius limitation that prohibits the owner and his related businesses from authorizing any other tenant or resident of these buildings to operate an outpatient surgery or treatment centre. The tenant`s motivation is to minimize (1) regulatory risks, as described above; and (2) avoid losing patients and stores to the CSA due to other competing suppliers operating near the CSA site. Before accepting such a restriction, the lessor must take into account not only the current tenants of its subsidiaries in neighbouring buildings, but also the possibility of renting available land to appropriate tenants in the future.
2011 should be an interesting year for the legal issues of the operational centre. One of the key issues we see is the strengthening of the enforcement of anti-kickback laws and related statutes, greater impatience on the part of doctors with regard to the activities of other doctors in the operations centres, a redoubling of physicians` efforts to find innovative ways to take advantage of operations centres, some expectation about the impact of the implementation of health system reform, a more in-depth examination of some contractual issues between FSB and joint venture hospitals, to determine whether they can enter into a contract together to obtain better rates of managed care. Finally, there will still be fights between the operational centres and the payers for the a-network refund. „An obvious concern is that you don`t want a surgeon to have a personal interest in a CSA that is two miles away. This leads to the problem of doctors with competing interests and would have an impact on the CSA that is developed and maintain the potential volume of its business. In general, we always put non-competition provisions in place in our enterprise agreements. Normally, it`s a 5-10 mile radius in New Jersey; As a general rule, it also extends after the doctor has left the CSA to protect the doctors who remain in front of a doctor who jumps the ship to go to a centre elsewhere. As a general rule, they are extended from one to two years after departure,“ says Kastner. seek an injunction from an appropriate court in Maricopa County, Arizona, or elsewhere to refrain from any actual or imminent violations by that member.