Gavin John N, Goodman George, Goroff David B
Law Firm of Foley & Lardner LLP, Chicago, IL, USA.
J Health Care Finance. 2007 Winter;34(2):10-37.
The owners of a health insurance/managed care business may want to sell that business for a variety of reasons. Health care provider systems may want to exit that business due to operating losses, difficulty in complying with regulations, the inherent conflict in operating that business as part of a provider system, or the desire to focus on being a health care provider. Health insurers/HMOs may want to sell all or a portion of their business due to operating losses, difficulty in servicing a particular market, or a desire to focus on other markets. No matter what reason prompts a seller to undertake a sale, a sale of health insurance/managed care business can be a complicated transaction involving a multitude of issues. This article will focus first on the ways in which such a sale may be structured. The article will then discuss some transactional issues that may arise in the negotiations for the sale of a health insurance/managed care business. The article will then focus on some particular legal issues that arise in each sale-e.g., antitrust, HIPAA, regulatory approvals, and charitable issues. Finally, this article will provide an overview of tax structuring considerations.
出于各种原因，健康保险/管理式医疗业务的所有者可能想要出售该业务。医疗服务提供系统可能因运营亏损、难以遵守法规、作为医疗服务提供系统的一部分运营该业务时存在的内在冲突，或专注于成为医疗服务提供者的愿望而想要退出该业务。健康保险公司/健康维护组织（HMO）可能因运营亏损、难以服务特定市场或专注于其他市场的愿望而想要出售其全部或部分业务。无论促使卖家进行出售的原因是什么，健康保险/管理式医疗业务的出售都可能是一项复杂的交易，涉及众多问题。本文将首先关注此类出售可能的架构方式。接着文章将讨论在健康保险/管理式医疗业务出售谈判中可能出现的一些交易问题。然后文章将聚焦于每次出售中出现的一些特定法律问题，例如反垄断、《健康保险流通与责任法案》（HIPAA）、监管批准和慈善问题。最后，本文将概述税务架构方面的考虑因素。
