February 13, 2025
 
 
Question:
Dear Jennifer,
 
I have an opportunity to invest in an ambulatory surgery center and I am wondering if there are any requirements or restrictions as to my investment?
 
Thanks,
Dr. S.

Answer:
Yes, absolutely, there are a number of restrictions against a physician to own in an ambulatory surgery center or "ASC". Notable restrictions include restrictions against a physician - 
  • receiving loans or guarantees from the ASC to induce physician investment
  • terms of investment can't be tied to patient referrals or services to be furnished or business generated from or for the ASC
  • the return on investment must be proportional to capital invested and reflect fair market value 
  • at least 1/3 of the physicians procedure income must be derived from procedures performed at the ASC
See https://oig.hhs.gov/faqs/general-questions-regarding-certain-fraud-and-abuse-authorities/  

Just from the short list above, you can see there are major restrictions on participation and ownership, and controls on how you can earn money based on capital investment.   If you are considering purchasing an interest in an ASC, we would start with looking at, why?  Is the ASC going to be an easy extension of your practice?  Is the capital investment and potential return going to be proportionate to your energy expenditure bringing cases?  Practically speaking, is the ASC staffed and available to meet your surgical needs?   These are just cursory questions we would consider, along with a deep financial dive into the finances of the ASC to consider the benefits of the investment...  

Happy to help in your assessment and potential joinder.