Medical Practice Attorney • Boerne, Texas

Medical Practice Attorney in Boerne

By · Managing Partner
Last updated

Physician practice acquisitions carry a regulatory layer that standard business transactions do not. Corporate Practice of Medicine rules, Medicare and Medicaid provider number transfers, Stark Law compliance, and payor credentialing timelines all affect whether a deal closes cleanly and the practice keeps running. Our Boerne medical practice attorneys guide physicians buying and selling practices across Healthcare, Real Estate, Tourism and the healthcare sector, with Managing Partner Alex Lubyansky personally involved in every engagement.

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Selective M&A Practice
Personal Attention
Senior Counsel on Every Deal

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What We Do

Alex Lubyansky handles medical practice acquisition law work for buyers and sellers in Boerne and across the country. Here is what that looks like:

  • Purchase agreement drafting and negotiation for physician practice acquisitions
  • Corporate Practice of Medicine (CPOM) compliance and MSO structuring
  • Medicare and Medicaid provider number transfer and CHOW filing coordination
  • Payor contract assignment, credentialing, and insurance panel transfer
  • Stark Law and Anti-Kickback Statute (AKS) regulatory diligence
  • Physician employment agreement, partnership buy-in, and non-compete negotiation
  • Staged acquisition structuring (51% initial purchase with remainder option)
  • Psychiatry, behavioral health, and specialty practice acquisition counsel

Who We Serve

We work best with people who know what they want and are ready to move:

  • Physicians buying into or acquiring the practice where they currently work
  • Physicians doing a staged buy-in (initial percentage with option for remainder)
  • Medical practice owners selling to a physician group, PE platform, or hospital system
  • Psychiatrists or psychotherapists buying or selling a behavioral health practice
  • Physicians negotiating a partnership buy-in or co-ownership structure
  • Private equity healthcare platforms acquiring physician practices

See If Your Deal Is a Fit

Tell us what you are working on. We respond within one business day.

Your information is kept strictly confidential and will never be shared. Privacy Policy

Our Process

A structured, methodical approach to medical practice acquisition law

1

Regulatory Landscape Review

We assess the CPOM posture, Stark and AKS exposure, CON requirements, and Medicare and Medicaid provider number transfer mechanics for your specific transaction before any term sheet is signed.

2

Deal Structure and MSO Design

Managing Partner Alex Lubyansky structures the acquisition to respect CPOM limits, optimize risk and tax treatment, and where needed designs an MSO or friendly-PC arrangement that preserves clinical independence while delivering the economic deal.

3

Healthcare-Focused Due Diligence

We conduct diligence across payor contracts, Medicare and Medicaid enrollment, compliance program maturity, malpractice history, physician employment agreements, and patient volume concentrations to surface risks before closing.

4

Purchase Agreement and Ancillary Documents

We negotiate the purchase agreement, physician employment or non-compete terms, transition services arrangement, and earnout provisions tied to clinical performance metrics specific to the practice type.

5

Closing and Clinical Continuity

We coordinate CHOW filings, payor credentialing timelines, and post-closing integration to ensure patient care and reimbursement continue without interruption from day one of your ownership.

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What Happens After You Submit

We don't take every matter. Here is what happens when you reach out.

1

Personal Review (Within 24 Hours)

Alex reviews your transaction details personally. No intake coordinators, no junior associates screening your submission.

2

Fit Assessment

We evaluate whether your deal aligns with our practice. Not every matter is a fit, and we will tell you directly if it is not.

3

Initial Conversation

If there is alignment, Alex schedules a direct call to discuss your transaction, timeline, and objectives.

4

Clear Engagement Terms

Before any work begins, you receive a written engagement letter with defined scope, timeline, and fee structure. No surprises.

Request Your Boerne Engagement Assessment

Alex Lubyansky handles every medical practice acquisition law engagement personally.

15+ years of M&A experience. Nationwide. One attorney on every deal.

Request Engagement Assessment

We review every transaction inquiry within one business day.

Your information is kept strictly confidential and will never be shared. Privacy Policy

Questions to Ask Any M&A Attorney Before Hiring

Use these before you call any firm, including ours.

1. "Who will actually handle my transaction?"

At many firms, a partner sells the work and a junior associate does it. Ask for the name of the attorney who will draft and negotiate your documents.

2. "How many M&A transactions has the lead attorney closed in the past 12 months?"

Volume indicates current, active deal experience, not just credentials from years ago.

3. "What is your experience with my deal size and industry?"

A $500K SBA acquisition and a $50M PE deal require different skill sets. Make sure the attorney has handled transactions similar to yours.

4. "Will you coordinate with my CPA, financial advisor, and broker?"

M&A transactions require a team. Your attorney should work with your other advisors, not in a silo.

5. "How do you handle post-closing disputes?"

Reps, warranties, and indemnification claims surface months after closing. Ask whether the firm handles post-closing litigation or refers it out.

6. "What is your fee structure, and what drives cost?"

Ask how the engagement is scoped, what is included, and what factors drive cost increases. Defined scope with a retainer gives the clearest cost picture.

Frequently Asked Questions

Common questions from Boerne clients

What does a medical practice attorney do?
A medical practice attorney handles the legal and regulatory side of buying or selling a physician practice. This includes structuring the deal to comply with Corporate Practice of Medicine rules, conducting diligence on payor contracts and Medicare enrollment, negotiating the purchase agreement and physician employment terms, and coordinating provider number transfers. At Acquisition Stars, Managing Partner Alex Lubyansky personally handles every physician practice transaction.
What is a staged acquisition of a medical practice?
A staged acquisition is a common structure where the buyer acquires an initial ownership percentage, often 51%, with a contractual right or obligation to purchase the remaining interest over time. This structure lets the buyer begin building equity while the seller transitions gradually, and it can align incentives around patient retention and practice performance. The legal documents must carefully address buy-in price, trigger conditions, and each party's rights during the interim period.
How does Corporate Practice of Medicine affect a physician practice acquisition?
Most states restrict ownership of medical practices to licensed physicians. When a non-physician buyer is involved, the deal typically requires a Management Services Organization structure that separates the clinical entity from the business operations. In strong CPOM states, the structure must hold up under state scrutiny while still delivering the economic deal the parties negotiated. We design structures that work in your specific state.
What happens to Medicare and Medicaid enrollment when a practice is sold?
Medicare and Medicaid provider numbers and enrollment do not automatically transfer to a new owner. Depending on the transaction structure, the buyer may need to file a Change of Ownership (CHOW) with CMS, apply for new enrollment, or reassign billing privileges. The timing of these filings directly affects cash flow after closing. We build the provider number transition into the deal timeline so reimbursement does not stall.
Can a physician buy the practice they currently work at?
Yes, and it is one of the most common physician practice transactions we handle. The physician already knows the patient base, the payor mix, and the operations, which simplifies due diligence but creates its own negotiating dynamics. Key issues include how the practice is valued relative to the physician's existing compensation, how a transition period is structured if the selling physician stays on, and how non-compete terms are written to reflect the physician's prior relationship with the practice.
What can I expect during an initial consultation in Boerne?
During your confidential initial consultation in Boerne, we'll discuss your medical practice acquisition law needs, review your current situation, assess potential challenges specific to Texas, and outline a clear path forward. We'll explain our process, answer your questions, and determine if we're the right fit for your needs.
Do you work with companies outside of Boerne?
Yes, we represent clients nationwide while maintaining a strong presence in Boerne. Our managing partner handles medical practice acquisition law matters across all 50 states, coordinating with local counsel where state-specific requirements apply.

Need Specific Guidance?

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Your information is kept strictly confidential and will never be shared. Privacy Policy

M&A Market: Boerne & the San Antonio Metro

San Antonio's M&A market is significantly influenced by its massive military presence, with Joint Base San Antonio (the largest joint base in the DoD) driving deal activity in defense contracting, cybersecurity, and government IT services. The city is also a major healthcare market, home to the South Texas Medical Center and a growing biosciences sector. San Antonio's lower cost structure compared to Austin and Dallas makes it an increasingly attractive market for mid-market acquisitions in manufacturing, energy services, and hospitality.

Top M&A Sectors Near Boerne

  • Defense & Cybersecurity Services
  • Healthcare & Medical Services
  • Energy & Oil Field Services
  • Hospitality & Tourism
  • Manufacturing & Aerospace Components

Deal Environment

San Antonio offers attractive valuations relative to Austin and Dallas, with deal multiples typically 0.5-1 turn lower for comparable businesses. The military community creates a unique pipeline of veteran-owned businesses approaching transition, and the city's steady population growth fuels demand for healthcare and consumer services acquisitions.

Why Acquire in the San Antonio Area

San Antonio is the second-largest city in Texas and the seventh-largest in the U.S., with population growth that consistently outpaces the national average and a cost of doing business well below other major Texas metros. The city's $40B+ military economic impact provides a stable demand floor for defense and services businesses.

Texas Legal Considerations

Texas enforces non-compete agreements if they are ancillary to an otherwise enforceable agreement and meet reasonableness requirements, and the state's lack of a corporate or personal income tax makes post-acquisition cash flow modeling more favorable, though buyers should account for Texas's franchise (margin) tax on entities with revenue exceeding $2.47 million.

Texas Legal Considerations for Medical Practice Acquisition Law

Non-Compete Laws

Enforceable only if ancillary to an otherwise enforceable agreement. Mandatory reformation.

Filing Requirements

Entity mergers and conversions must be filed with the Texas Secretary of State. Franchise tax (margin tax) compliance is required. The Comptroller's office handles tax clearance certificates for asset purchases. Public Information Reports are required annually.

Key Texas Considerations

  • Texas has no corporate or personal income tax, making it one of the most favorable jurisdictions for structuring acquisitions, though the Franchise (Margin) Tax still applies as a gross-receipts-based tax
  • As a community property state, spousal consent is required for the sale of community property business interests, adding a required step in deal documentation
  • Texas's unique requirement that non-competes be "ancillary to an otherwise enforceable agreement" means buyers must carefully evaluate the enforceability of each non-compete in a target company's portfolio based on the underlying consideration

Texas Bar Authority

State Bar of Texas (mandatory unified bar). Unified/integrated bar. Membership required to practice law in Texas.

Bar association website

Texas Federal and Business Courts

Federal districts: N.D. Tex., S.D. Tex., E.D. Tex., W.D. Tex.

Business court: Texas Business Court (established 2024) Established by HB 19 signed in 2023; became operational September 1, 2024. Eleven divisions statewide, five divisions initially open. Concurrent jurisdiction with district courts in matters over $5 million including corporate governance, shareholder disputes, fiduciary claims, and state or federal securities law. The Fifteenth Court of Appeals serves as the dedicated appellate court, making Texas the first state with a dedicated business court appellate track.

Texas M&A Market Context

Texas is the second-largest U.S. M&A market, with Houston (energy), Dallas-Fort Worth (technology, financial services), and San Antonio as major deal-flow centers across all industry verticals.

Recent Texas Legislative Changes (2024-2025)

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Watchpoints

Common Boerne Medical Practice Acquisition Law Pitfalls

These are the items we see derail medical practice acquisition law transactions in the Boerne market. Each one is rooted in current statutory law, recent legislative changes, or recurring patterns from the deals Alex has handled.

1

Recent Texas statutory change buyers and sellers miss

State statute

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2

Texas non-compete enforcement and earn-out exposure

State legal framework

Enforceable only if ancillary to an otherwise enforceable agreement. Mandatory reformation.

"The most expensive deals aren't the ones with high price tags. They're the ones where buyers skipped the 90-minute assessment because they fell in love with the highlight reel."
Alex Lubyansky · Alex LinkedIn Published (Notion library)
3

Texas regulatory framework attorneys flag at LOI

State statute

Securities regulated by Texas State Securities Board (ssb.texas.gov). Texas follows the Texas Securities Act (Tex. Gov't Code Title 12); Blue Sky notice filings required for Reg D. Texas enforces non-competes only if part of an otherwise enforceable agreement and supported by adequate consideration (Tex. Bus. Com. Code sec. 15.50).

Guides and Resources

In-depth guides to help you prepare for your transaction

M&A Legal Services

Full-service M&A counsel from letter of intent through closing.

Read guide

Due Diligence Checklist

A structured approach to legal, financial, and operational due diligence.

Read guide

LOI vs Purchase Agreement

Understanding the binding and non-binding elements of each document.

Read guide

Why Deals Fail

Common deal-killers and how experienced counsel helps prevent them.

Read guide

Other Medical Practice Attorney Service Areas Near Boerne

Acquisition Stars represents clients across Texas and nationwide. Alex Lubyansky handles every engagement personally.

Alamo Heights medical practice attorneyserving Terrell HillsShavano Park medical practice attorneymedical practice attorney in Fair Oaks Ranchserving Helotesserving Bulverdeserving New BraunfelsSchertz medical practice attorney

Don't see your city? View all Medical Practice Attorney service areas or contact us directly.

Related Services in Boerne

Statewide and Nearby Markets

Helpful Resources

Attorney perspective on medical practice attorney matters in Boerne

Alex Lubyansky, Managing Partner at Acquisition Stars
"The best victories happen when everyone feels like they contributed to the win."
Alex Lubyansky, Senior Counsel On negotiation (principle) (Alex LinkedIn Published (Notion library))

15+ years of M&A and securities transaction experience Senior counsel on every engagement Admitted in Michigan, practicing nationwide

Reviewed by Alex Lubyansky on . Read full bio

Ready to Talk About Your Boerne Deal?

Alex Lubyansky handles every engagement personally. Tell us about your transaction and we will let you know if there is a fit.

Request Engagement Assessment

Tell us about your deal. We review every submission and respond within one business day.

Your information is kept strictly confidential and will never be shared. Privacy Policy

One attorney on every deal. Nationwide. 15+ years of M&A experience.