Holt Law - Healthcare Business Law Firm

Holt Law - Healthcare Business Law Firm The Law Firm Built for Healthcare Businesses. Licensed in California and Minnesota. We help individuals and businesses in healthcare and business matters.

I'm Minnesota's 3rd worst cribbage player that also happens to be a Healthcare and Business Attorney. Casual attire preferred; so far, wearing a tie has not made me a better attorney.

09/02/2026

Comprehensive and brief at the same time is possible. It is also not the same as complete.

Went in expecting a slower, more considered response this time, the kind you would expect from a version built to actually think through a problem.

What came back felt more like a fast, surface level reply instead.

To be fair, it was still pretty comprehensive for how short it was. It touched the right areas and did not get anything obviously wrong.

The real issue showed up after reading it. Instead of landing on a clear answer, it left more open questions than it resolved, exactly the kind of questions a client would then need a real conversation to work through.

That gap, comprehensive but incomplete, is often harder to catch than an answer that is flatly wrong.

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09/02/2026

The writing was genuinely good. It still did not sound like it came from someone who lived through the answer.

Looked at a piece of content this week that was very well written, likely pulled from another attorney's blog somewhere. The opening line alone was strong, and worth noting, a good opening does not have to lead with a flat fee to work.

Overall, hard to disagree with most of it. But it was missing something that is difficult to name precisely and easy to notice once you feel its absence. Context. Flavor. The sense that whoever wrote it had actually sat across from a client dealing with this exact problem.

That gap does not show up as an error. It shows up as writing that is technically correct and still feels slightly hollow.

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A single operating company holding everything sounds simple. It's the reason deals get harder, not easier.The building, ...
09/01/2026

A single operating company holding everything sounds simple. It's the reason deals get harder, not easier.

The building, the equipment, and the practice often get acquired under whichever entity happened to exist at the time, and everything ends up sitting in one place.

That works fine until a claim shows up. When operations and property share an entity, a claim against one reaches the other. Lender security ends up encumbering assets that were never part of the loan. A partial sale means carving pieces out mid-process instead of simply handing them over.

Succession offers no clean way to transfer one part alone.

Separating the real estate, the equipment, and the operating practice into their own entities under one holding company changes that. Each piece can be financed, leased, or sold on its own terms, without dragging the rest of the business along with it.

Structure decides how many options are actually available when it's time to sell, finance, or hand something off.

Swipe to see how the entities split.

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09/01/2026

A version of this question comes up specifically from a cost saving angle. Can an MSO hire associate physicians, locum tenens, or advanced practice providers as 1099 independent contractors, to lower tax and benefit overhead.

The motivation makes sense on paper. 1099 classification looks like it trims payroll tax and benefits costs compared to bringing someone on as a W2 employee. The problem is the answer does not change based on why you are asking. An MSO still cannot hire clinical providers, 1099 or W2, because it runs into the corporate practice of medicine doctrine either way.

Chasing the tax savings through this particular structure does not get you there. It just adds a compliance issue on top of the overhead you were trying to reduce.

If cost is the driver behind how your clinical staff are classified, that savings needs to come from somewhere that is actually allowed.

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09/01/2026

A good question is not free. Someone still has to know enough to ask it.

A fair question comes up often. Could you just build a prompt smart enough to automatically figure out the right questions to ask.

Probably, to some extent. A well built prompt could likely capture most of what is actually needed in a given situation.

Here is the part that does not go away. Building that prompt, or even knowing to ask that first question at all, still requires someone who already understands enough about the subject to know what matters. The tool can organize the knowledge. It cannot generate the judgment that decides which questions are worth asking in your specific situation.

That is the piece that keeps a human in the loop, no matter how good the prompt gets.

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08/31/2026

This area of California healthcare law is genuinely unsettled, and that is not an exaggeration for effect. There is real disagreement, both a minority and a majority legal opinion, and it shows up inside the healthcare legal community itself, among attorneys in California and nationally.

Part of that disagreement sits right between the California Attorney General's current stance and the position taken by attorneys representing MSOs. Neither side is operating on a settled answer.

In situations like this, the more conservative reading matters. That reading points toward flat fees or a cost plus structure, the actual cost of services plus a small percentage, rather than a straight percentage of revenue.

If your compensation structure is not built around one of those two models, this is worth understanding while the law is still this unsettled.

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08/31/2026

This is what it looks like when years of writing about this stuff actually pays off.

Something worth pointing out while looking through these search results. Gemini is actively citing our own blog content, and in some cases, it is essentially reciting a rule the way we originally wrote it.

That is a useful reminder of what AI actually is in moments like this. It is not generating new legal insight out of nowhere. It is drawing from content that real people, often practicing attorneys, took the time to research and write clearly.

Which means the depth and accuracy of what is published online is becoming more important, not less. If the source material is thin or wrong, that is what gets repeated at scale. If it is thorough and correct, that is what shows up when someone asks the question.

This is exactly why we keep publishing detailed, practical healthcare law content instead of generic posts. It is what ends up helping people, whether they read it directly or find it through a search result.

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08/28/2026

This episode looked at how Gemini handled a real labor law question, specifically the Borello test and the ABC test, both used in California to determine whether someone is properly classified as an independent contractor or an employee.

The AI held up well here. A human attorney might get to the answer slightly faster in a live conversation, but the substance of Gemini's response was solid, correctly walking through both tests and how they apply.

This is a good example of AI performing close to its ceiling, a well established area of law with clear tests already defined. The harder cases are usually the ones without a clean test to apply, and that is where the gap tends to show up.

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08/28/2026

Compliant under federal law does not automatically mean compliant in California.

California has its own set of state specific rules that sit on top of federal law, and that overlay is not optional to consider. It has to be part of the actual legal analysis, not an afterthought once the federal side checks out.

This shows up constantly in healthcare. Stark Law is federal, but California's Physician Ownership and Referral Act adds its own layer on top of it. Fee splitting rules exist federally and at the state level, often with different nuances. Corporate practice of medicine is a state doctrine entirely, with California enforcing it more strictly than most.

Clearing the federal bar and assuming that settles the question is exactly where practices get caught off guard. The real answer almost always requires checking both.

If a structure or compensation arrangement has only been evaluated against federal law, that is an incomplete answer, not a safe one.

Talk with Holt Law about your next growth decision: https://hubs.ly/Q04vKz2G0

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Fast growth feels like proof that everything underneath it is working.Patients, pricing, and delivery clearly are.But th...
08/27/2026

Fast growth feels like proof that everything underneath it is working.

Patients, pricing, and delivery clearly are.

But that's market demand, not legal durability, and it doesn't answer whether the revenue behind it can actually be defended or transferred.

The risk is that a structural gap rarely stays a single gap. Whatever wasn't buttoned up at one location shows up again at four, and again at every site after that.

Buyers notice. Unsupported service lines get excluded from earnings, indemnities get wider, and the valuation multiple only gets applied to revenue that can withstand a closer look.

The fix isn't complicated: validate new services before they carry revenue, replicate one clean model at every new location instead of improvising each time, and review the structure on a schedule tied to growth milestones, not after a problem shows up.

Talk with Holt Law about your next growth decision: https://hubs.ly/Q04vCTpv0

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