Dental Service Organizations Industry Group

Overview

One of the fastest-growing areas of the $110 billion-a-year dental industry is the Dental Service Organizations (DSO) segment. Although the 20 largest DSOs—with combined annual sales of $6 to $7 billion—represent just slightly more than five percent of the total U.S. dental industry, the growth of this segment is fast outpacing that of the solo practitioner. With continued consolidation, either through mergers or acquisitions, DSOs stand to gain a more dominant presence in this important industry.

The legal needs of DSOs are many and diverse, and require comprehensive counsel and experienced representation on a wide array of sophisticated matters: from handling all matters of regulatory issues (among them: advertising, billing, patient finance, HIPAA) through preventive counseling to litigation; from assisting in M&A transactions to evaluating and completing real estate acquisitions or sales; from crafting practice purchase agreements to developing partnership and shareholder covenants; from providing sophisticated tax counsel to offering the full suite of estate planning services.

Dykema’s DSO group offers a multi-discipline team that provides top-tier counsel, whose demonstrated accomplishments and proven experience cover the entirety of the business and legal needs that are unique to Dental Service Organizations. Our practitioners—whose areas of experience range, as shown below, from Litigation to Real Estate, Tax to Brand Protection, Mergers & Acquisitions to Employment Law, Health Care to Government Investigations and Corporate Compliance—provide, both individually and collectively, top-tier legal representation and "go-to" strategic counsel.

In addition to the services we provide to DSOs, we also annually host our Definitive Conference for Dental Service Organizations. More information can be found at www.dykemadso.com.

The key members of our DSO team are profiled below.

Dykema Dental Service Organizations Group

Brian A. Colao, Director

Brian is the Director of Dykema’s Dental Service Organizations Industry Group. He is widely regarded as one of the foremost authorities in the United States on the corporate practice of dentistry, illegal fee splitting and the related regulations, including advertising regulations, laboratory regulations, patient finance regulations, billing regulations, HIPAA regulations, credentialing, permit and licensure regulations, marketing regulations, and labor law regulations affecting dental practices.

Brian specializes in the representation of DSOs nationwide in the following areas:

  • Creating regulatory compliant business models and conducting ongoing compliance on a broad range of issues applicable to the industry
  • Defending DSOs in all manner of litigation and regulatory actions including State Dental Board Investigations and Complaints, State Attorney General Investigations and Complaints, Federal Investigations and Complaints, and private legal proceedings involving affiliated doctors
  • Assisting Private Equity Investors in buying, selling, or investing in Dental Service Organizations

In recent years Brian has successfully resolved on behalf of his clients several significant civil and criminal Medicaid fraud investigations and state dental board actions alleging the corporate practice of dentistry, fee splitting and related violations, and he is the “go to” person in the industry for all manner of regulatory issues. Brian has also handled as lead regulatory counsel some of the most significant transactions in the industry on behalf of buyers, sellers, lenders, or potential investors. In recent years Brian has handled at least ten significant dental transactions representing in excess of $2.5 billion of total value. Brian also assists lenders in conducting due diligence prior to extending credit to Dental Service Organizations.

Brian currently has clients in 46 states and has appeared before 37 separate state dental boards. Brian got his start in this industry approximately 15 years ago when he represented a group of 90 orthodontists in litigation with OrthAlliance, Inc. and Orthodontic Centers of America and handled cases of first impression involving the corporate practice of dentistry and fee splitting in 18 states that resulted in legal opinions that defined and established the law in this area.

Strategic Planning and DSO Transactions

Jeffrey M. Dalebroux

Jeff is a Member of Dykema's Corporate Finance Practice Group, the former Director of the Business Services Department and a member of the Dental Service Organizations Group. Jeff’s practice encompasses the preparation of regulatory compliant business agreements between DSOs and their affiliated practices and dentists as well as other third parties. Jeff also assists private equity groups and other investors in buying and selling DSOs and their affiliated practices. Over the last two years Jeff has worked on a number of significant dental transactions on behalf of buyers, sellers, lenders or potential investors.

Gerald T. Lievois

Jerry is a member of Dykema’s Corporate Finance Practice Group and Dental Service Organizations Group. He is experienced in DSO mergers and acquisitions, and assists private equity groups, other investors and their portfolio companies in DSO acquisition transactions.

Over the last few years, Jerry has worked on a number of significant DSO acquisition transactions. He also counsels DSOs in the preparation of regulatory compliant business agreements between DSOs and their affiliated practices and professionals.

DSO Compliance with State and Federal Regulations

Phyllis Adams

Phyllis is the former Leader of Dykema’s Health Care Practice Group and presently a member of the firm’s Executive Board and Dental Service Organizations Group.

Prior to becoming an attorney Phyllis was a licensed dental hygienist and also spent many years managing dental practices. She is highly experienced in the corporate practice of dentistry, illegal fee splitting and the related regulations, including advertising regulations, laboratory regulations, patient finance regulations, billing regulations, HIPAA regulations, credentialing, permit and licensure regulations, and marketing regulations affecting dental practices. Phyllis is skilled in reading dental records and has considerable experience defending compliance audits from state and federal government agencies as well as private payers.

Kathrin E. Kudner

Kathy is a member of Dykema’s Health Care Practice Group and Dental Service Organizations Group.

Kathy has experience in a broad range of dental compliance issues, including mergers and acquisitions, corporate practice of dentistry, Medicaid compliance billing audits, HIPAA/HITECH, and application of the Affordable Care Act to DSOs, including the Sunshine Act. Kathy regularly advises DSO and dental clients on compliance with regulations relating to the manufacture and sale of dental devices, the prescription and dispensing of prescription drugs and controlled substances, scope of practice, and occupational safety. She has broad experience in responding to and defending compliance and billing audits and HIPAA complaints from state and federal government agencies. She is a foremost authority on HIPAA compliance and the new Affordable Care Act regulations. Kathy works with numerous DSOs in developing compliance programs, including policies and procedures, trainings and compliance audits.

Maria B. Abrahamsen

Maria is the Leader of Dykema's Health Care Practice Group and a member of the Dental Service Organizations Group.

Maria’s practice is devoted to representation of health care facilities and practitioners, including DSOs, in corporate and regulatory matters, with an emphasis on payment issues. She has extensive experience with federal anti-kickback and Stark laws, and has a sophisticated understanding of the corresponding state regulations related to patient referral issues.

Kathleen A. Reed

Kathleen is a member of Dykema’s Health Care Practice Group and Dental Service Organizations Group. She has broad experience in the federal and state regulation of pharmacy and drug control and resale issues, fraud and abuse, scope of practice, licensure and regulatory matters, and patient care issues.

Kathleen is also a registered nurse who has significant experience working in both the clinical and business office aspects of dental practices.

DSO Credentialing, Permits and Certifications

Eric S. Klein

Eric is a member of Dykema’s Health Care Practice Group and Dental Service Organizations Group.

Eric has significant experience with the licenses, permits and certifications required to operate dental practices, including dental licenses, radiation permits, tax certificates, controlled substance permits and hazardous waste certifications. Eric also has considerable experience in the licensure of foreign dentists and the residency requirements for out-of-state owners of dental practices.

DSO Brand Protection

Victor C. Johnson

Victor is a member of Dykema’s Intellectual Property Practice Group and Dental Service Organizations Group.

Victor assists DSO clients with all types of intellectual property litigation and prosecution matters, including patent, trademark and copyright infringement; unfair competition and theft of trade secret litigation; securing trademarks and patents with the USPTO; and securing copyrights with the Copyright Office. He also assist sDSO clients on intellectual property due diligent matters, including validity and non-infringement opinions; advice on designing around patents; and negotiating and licensing of IP rights.

Eric T. Fingerhut

Eric is the Leader of Dykema’s Trademark Practice Group and a member of the Dental Service Organization Group.

Ranked as a First Tier trademark lawyer by the World Trademark Review, Eric has significant experience representing Dental Service Organizations in clearing new marks and logos, registering trademarks, copyrighting proprietary information on practice development, and protecting trademarks, trade dress and web domain names through applicable legal proceedings. He has spent considerable time registering and maintaining catalogues of Dental Industry specific trademarks and copyrights for a variety of DSOs. Eric has significant experience in filing trademark and copyright infringement lawsuits, and trademark opposition and cancellation actions to protect Dental Industry Company brands. Recently, he successfully represented ClearChoice in an opposition it filed with the Trademark Trial and Appeal Board. The case pitted ClearChoice's CLEARCHOICE mark against an application to register the mark REAL CHOICE. He also regularly appears before the Internet Corporation for Assigned Names and Numbers (ICANN) in connection with internet domain name disputes.

Zachary Q. Hoard

Zack is a member of Dykema’s Business Litigation Group and Dental Service Organizations Group. He has successfully represented clients in several state dental board actions and traditional litigation disputes regarding allegations of the corporate practice of dentistry, fee splitting and related violations.

Zack also has considerable experience in filing trademark and copyright infringement lawsuits, and trademark opposition and cancellation actions to protect Dental Industry Company brands.

DSO Patient Finance

Eric L. White

Eric is a member of Dykema’s Corporate Finance Practice Group and Dental Service Organizations Group. He is experienced in DSO transactions and assists private equity groups, lenders and other investors in buying and selling DSOs and their affiliated practices and providing financing for such transactions. Eric represents DSO clients across the United States.

In his career of nearly two decades, Eric has worked on a number of significant dental and practice finance transactions on behalf of buyers, sellers, lenders and potential investors. He counsels DSOs, investors and practice owners on sophisticated dental business issues, including regulatory compliant DSO and practice ownership structures and governance, and best practices regarding load structures.

Eric also specializes in the preparation of regulatory compliant business agreements between DSOs and their affiliated practices and professionals, as well as other third parties.

Government Investigations and Corporate Compliance

Jonathan S. Feld

Jonathan Feld is the Leader of Dykema’s Government Investigations and Corporate Compliance Team and a member of the Dental Service Organizations Group.

Jonathan’s practice focuses on complex civil and criminal matters, including antitrust, health care fraud, financial and antibribery actions. He represents companies, directors and officers in investigations and enforcement actions by the U.S. Department of Justice (DOJ), Securities and Exchange Commission (SEC), the U.S. Department of Housing and Urban Development (HUD), the Food and Drug Administration (FDA) and other regulatory agencies. Jonathan advises corporations, boards of directors and board committees regarding internal investigations, corporate compliance programs and corporate governance issues, including the Foreign Corrupt Practices Act (FCPA) and data privacy. He former served as an Associate Deputy Attorney General at the DOJ.

DSO Tax Regulations

Anthony Ilardi, Jr.

Tony is a member of Dykema’s Taxation Practice Group and Dental Service Organizations Group.

Tony has significant experience representing DSOs in developing and documenting tax advantageous ways to acquire affiliated practices, sell affiliated practices and transfer ownership in practices. He also has experience representing clients in connection with tax audits and in tax litigation.

Tony also advises DSOs with respect to transferred assets in order to ensure appropriate tax treatment.

DSO Employment Issues

Alison R. Ashmore

Alison is a member of Dykema’s Labor & Employment Practice Group, Business Litigation Group and Dental Service Organizations Group.

Alison works with clients to resolve all manner of business issues and business disputes, including contractual disputes, protection of confidential information and intellectual property, breach of fiduciary duty, non-compete enforcement, fraud, unfair competition, and other business claims, as well as employment issues and bankruptcy claims. She has broad experience representing DSOs with employment litigation and advising them on reducing litigation risks and employment law compliance issues. She represents employers and businesses in both state and federal court and before the Equal Employment Opportunity Commission. Alison also has experience representing clients pursuing appeals in both Texas appellate courts and the Fifth Circuit Court of Appeals

Arlene Switzer Steinfield

Arlene is a member of Dykema’s Labor & Employment Practice Group, Employment Litigation Group, Dental Service Organizations Group, Biotechnology and Life Science Group, Health Care Practices Group, Hospitality Practice Group, and the Pharmaceuticals & Medical Products Practice Group.

Arlene has represented DSOs, medical practice groups, physicians, dentists and hospitals in connection with employment litigation in state and federal court, devising preventative compliance strategies for employee terminations while reducing the risk of litigation, and providing advice in connection with internal audits of personnel practices, and the preparation of personnel policies and handbooks. Arlene also advises employers on wage-hour compliance, conducts internal investigations for health organizations on claims of discrimination and harassment, and provides training to health care employers on employment law compliance.

Government & Regulatory Litigation

Matthew D. Rinaldi 

Matt is a member of Dykema’s Litigation Practice Group and Dental Service Organizations Group with a focus on Government and Regulatory Litigation.

Matt has considerable experience working with health care providers on a variety of litigation matters, including those relating to government disputes and regulatory compliance. Matt also brings substantive regulatory and government litigation experience in securities, intellectual property, antitrust, financial institutions, technology and election law, among other areas, and a familiarity with litigation involving state and local government. Matt is also a Texas State Representative and serves on the House Committee on Business & Industry.

Leonard C. Wolfe

Len is a member of Dykema’s Government Policy Practice Group and Dental Service Organizations Group. He is also currently a member of the firm’s Executive Committee and a former Director of the firm’s Regulated Industries Department.

Len’s practice encompasses several areas of legal representation, including general corporate matters, public policy litigation, government reorganization and restructuring, and general administrative law (including representing clients before various state departments, agencies and boards). He has been involved in the drafting of complex legislation and administrative rules on a variety of matters, including compliance and licensing matters, economic development, Freedom of Information Act (FOIA) and state ethics and conflicts of interest. In addition, Len has experience with other governmental matters, including department and agency investigations, Office of Auditor General performance audits and the drafting of Interlocal Agreements, Intergovernmental Transfer Agreements, Executive Orders and Executive Directives, as well as Advisory Opinion requests.

Speaking Engagements