Purvi B. Maniar

Norton Rose Fulbright US LLP

St. Louis
United States
T:+1 314 505 8816
New York
United States
T:+1 212 318 3000
St. Louis
United States
T:+1 314 505 8816
New York
United States
T:+1 212 318 3000
Purvi B. Maniar

Purvi B. Maniar



Purvi Maniar is a member of Norton Rose Fulbright's healthcare transactions team and is a partner based in the firm's St. Louis and New York offices. She is a healthcare business lawyer who advises hospitals, health systems, life sciences companies, medical group practices, behavioral health organizations, emerging healthcare companies and private equity clients in mergers, acquisitions, joint ventures and other strategic business arrangements. Purvi focuses on both domestic and international healthcare transactions and helped lead the expansion of the global law firm's high caliber domestic health system practice to include international healthcare transactions.

Purvi also focuses significantly on the area of behavioral health. She represents private equity backed companies and prominent non-profit behavioral health providers in connection with their mergers, acquisitions, strategic partnerships and clinically integrated networks. She also advises hospitals in connection with their inpatient behavioral health programs, as well as tele-behavioral health providers and other clients focused on the behavioral health space. She serves as Chair of the Behavioral Health Practice Group of the American Health Lawyers Association.

Purvi works with her clients and industry players to build new synergies in the healthcare sector across the country and internationally. She has successfully represented hospitals in their mergers, acquisitions and domestic and international joint ventures; private equity-backed companies with their investments, acquisitions and sales in the healthcare services sector; and large medical practices in their formation, acquisitions, strategic alliances and sale.

Professional experience

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JD, Georgetown University Law Center
BA, Rutgers University

  • District of Columbia Bar
  • Missouri State Bar
  • New York State Bar

Purvi has represented and advised a variety of key health industry participants in significant projects, including:

Hospitals and health systems

  • Prominent academic medical centers in Texas, Minnesota and Missouri in connection with various joint ventures with private equity back companies in the areas of urgent care, home care and hospice, hospital-at-home programs and other non-acute service lines.
  • Hospital based accountable care organization in connection with:
    • Renegotiation and renewal of orthopedic service line co-management arrangement between specialty hospital and multiple orthopedic practices, and 
    • Business critical strategies and implementation thereof to retain ACO status in light of material regulatory changes and resulting departures of member organizations.  
  • Chicago health system in a sale of hospital-owned Medicaid and Medicare managed care plans.
  • Prominent academic medical center in New York a sale of a Medicare managed care plan.

International hospital transactions

  • Multi-country research project for a globally renowned academic medical cener across over ten countries to analyze local regulatory environment in each jurisdiction in connection with potential joint ventures related to the AMC's lab expertise.
  • Multi-country research project across over ten countries to review and analyze the local regulatory environment applicable to the practice of telemedicine and the provision of remote second opinions.
  • Prominent overseas joint venture to launch major hospital designed as an international center of excellence.

Life sciences

  • International dialysis provider in acquisition of assets of US life sciences company in six non-US countries.
  • Joint venture between major US pharmaceutical company and major US software and hardware companies in connection with physician hand held devices.
  • Joint venture between major US pharmaceutical company and large health insurance provider related to governmental pilot program related to disease management.
  • National IVF laboratory in sale to specialty healthcare services company.

Private equity and venture capital

  • Owners in restructuring of various private equity backed Article 28 ambulatory surgery centers in New York.
  • Sovereign wealth fund in connection with its acquisition of a minority stake in a US for profit health system.
  • Private equity investment firm in New York in connection with acquisitions in the areas of behavioral health, hospice and home health, allergy and asthma and other medical practices in multiple states.
  • Private equity backed hospital operator, in connection with the proposed acquisition of Texas hospital from another for profit hospital operator.
  • Hong Kong based company in connection with joint venture with a US based assisted reproductive technologies practice to establish a new, state of the art IVF clinic geographically accessible from China.

Behavioral health

  • Prominent, national non-profit addiction recovery services provider in connection with strategic transactions, acquisitions and design of a clinically integrated network
  • Private equity backed company acquiring substance use disorder and other behavioral health facilities in Georgia, California, Arizona, Illinois and other states.
  • Minnesota based health system in connection with strategic restructuring options related to inpatient behavioral health program.
  • Private equity backed company in connection with acquisition of detox laboratory business in New Jersey supporting addiction recovery facilities in multiple states.
  • Chair, of AHLA Behavioral Health Practice Group steering a group of behavioral health experts practicing in various settings, including in-house, non-profit and private practice settings to advance the understanding of laws affecting behavioral health, including laws related to the delivery of and reimbursement for treatment of mental illness, substance use disorders and developmental disabilities.  

         [Note: Also see behaviorial health publications and speaking engagements below.]


  • Largest integrated health system in New York in connection with the revision of its medical staff bylaws to incorporate telemedicine related policies.
  • UK based telemedicine provider in connection with telemedicine regulatory counseling in multiple US states.
  • Tele-behavioral health services provider for employees of large self-insured employers in connection with regulatory counseling including in areas of telemedicine, e-prescribing, privacy of behavioral health records in multiple states and formation and establishment of a "friendly professional corporation" and management company in Massachusetts. 

Medical practices

  • Large multi-specialty, multi-location physician group in New York in connection with its formation, acquisitions, strategic partnerships, regulatory matters and eventual sale.
  • Large multi-specialty, multi-location physician group in Connecticut in connection with various regulatory and transactional matters.
  • Various medical practices in connection with their strategic transactions with hospitals, health systems and private equity.


  • Chambers USA, Missouri: Healthcare, Chambers and Partners, 2022 - 2023
  • The Best Lawyers in America, Best Lawyers, 2020 - 2021
  • Best Lawyers - Health Care Law, Best Lawyers, 2022 - 2024
  • Midwest Trailblazer - American Lawyer Magazine, 2021 
  • Co-author, "How NY law affects scrutiny of health care PE transactions," Law360, June 29, 2023
  • Co-author, "EKRA Turns Five: Enforcement Trends and Questions" American Health Lawyers Association, May 31, 2023
  • Co-author, "Lorna Breen Act leads to new physician wellness Stark exception and AKS safe harbor" Norton Rose Fulbright Legal Update, May 30, 2023
  • Co-author, "A First Look at the Medicare CY 2023 Physician Fee Schedule Proposed Rule" Life Sciences and Healthcare, Norton Rose Fulbright Legal Update, July 18, 2022 
  • Author "Behavioral Health Transactions Outlook for 2022" American Health Law, January 2022
  • Co-author, "Reform of privacy rules related to substance use disorder treatment: Practical implications" Health Law Check-Up, Norton Rose Fulbright Legal Update, December 10, 2020
  • Co-author, "How behavioral health care rules are evolving for COVID-19," Law360, April 3, 2020
  • Co-author "Multi-State Behavioral Health Strategies - Value Creation and Challenges," White Paper, Norton Rose Fulbright and Duff & Phelps, May 2018
  • Co-author, "42 C.F.R. Part 2 in Retrospective: The 30-Year Journey of the Alcohol and Drug Abuse Treatment Confidentiality Regulations" American Health Lawyers Association, May 2017
  • Co-author "SAMHSA Finalizes Its Changes to Confidentiality of Substance Use Disorder Patient Records Regulations, February 1, 2017
  • Co-author, "SAMHSA Releases Final Rule to Modernize Confidentiality Requirements for Patients Seeking Treatment for Substance Use Disorders" American Health Lawyers Association, January 18, 2017
  • Co-author, "Opportunities and Challenges Under Medicaid Substance-Use Disorder Treatment System Reform" American Health Lawyers Association, November 17, 2016
  • Co-author, "Assignment Lessons: 8th Circuit Finds Assigned Non-Competes Enforceable — Under Certain Facts" Trade Secrets & Noncompete Blog, July 29, 2016
  • Co-author, "Behavioral Health and Population Health Management: Is It Time for Real Progress?" AHLA Journal of Health & Life Sciences Law, February 2016
  • Author, "Physician Owned Labs Affiliating with Hospitals" Health Law Advisor, January 20, 2016
  • Co-author, "Connecticut Law Changes Reporting and Governance Requirements for Health Care Entities Part 2: Requirements Applicable to Physician Groups with Connecticut Locations" Client Alert, July 31, 2015
  • Author, "Delaware Authorizes Public Benefit Corporations: Will the First State Be the First to Benefit Healthcare Organizations?" BNA Health Law Reporter, July 31, 2014
  • Co-author, "Connecticut Law Establishes New Reporting and Governance Requirements Applicable to Physician Groups with Connecticut Locations" Client Alert, December 11, 2014
  • Co-author, "Is a Hybrid Just What the Doctor Ordered? Evaluating the Potential Use of Alternative Company Structures by Healthcare Enterprises" ABA The Health Lawyer, April 30, 2013
  • Co-Author, "Are Hybrids Really More Efficient? A 'Drive-By' Analysis of Alternative Company Structures" ABA Business Law Today, September 21, 2012
  • Co-author, "Skillful Pilots Through Storms and Tempest – Different Issues to Consider in Physician Integration," AHLA Connections, December 29, 2011
  • Author, "U.S. – India Business Relationships in the Healthcare Sector are on the Rise," Business in South Asia: Legal Views and News, February 6, 2009
  • Author,  HIPAA Considerations for Intermediaries in Medical Tourism, April 30, 2008
  • Author, "Advancing U.S. –India Synergy In the Health Care Sector," The Metropolitan Corporate Counsel, June 10, 2007
  • "Integrating Behavioral and Physical Health," AHLA Webinar, February 16, 2023
  • "Behavioral Health Deal Trends & Considerations for the Year Ahead," BHB 2021 Outlook Webinar, January 21, 2021
  • "Behavioral health: The Post-Pandemic Transactional Landscape," Panelist, Norton Rose Fulbright Webinar, December 3, 2020
  • "Don't distress: Managing Internal Financial Challenges and Evaluating Opportunities in the Healthcare Market," Panelist, Norton Rose Fulbright Webinar, July 14, 2020
  • "Law Around the World: Global Transactions," Panelist, Sixteenth Annual Health Law Symposium, Austin, TX, January 24, 2020
  • "Telehealth and Telemedicine - Challenges and Opportunities," Providence Health and NYU Health, June 11, 2019 and January 24, 2019
  • "Is Bigger Better?" – Multi-State Strategies in Behavioral Health, AHLA 2018 Annual Meeting, June 27, 2018 
  • "Multi-State Behavioral Health Expansion-Navigating Multiple Regulatory Regimes"  AHLA Health Care Transactions Conference, Nashville, TN, May 10, 2018
  • "Investment in Behavioral Health – Drivers and Outlook" AHLA Webinar, April, 18, 2017
  • "Emerging Issues in Health Information Technology" South Asian Bar Association Webinar,  April 17, 2018
  • "Behavioral Health: Legal Issues in Private Sector Consolidation and Expansion" St. Louis University School of Law, November 7, 2016
  • "Behavioral Health: Legal Issues in Private Sector Consolidation and Expansion" St. Louis Area Health Lawyers Association, September 9, 2016
  • "Investments in Behavioral Health: Drivers and Outlook" Behavioral Health Crash Course Webinar, April 5, 2016
  • "Growing Your Business" Saint Louis International Women's Day, St. Louis, MO, March 8, 2013
  • Chair, American Health Law Association (AHLA) Behavioral Health Practice Group
  • Member, Women Business Leaders in the Healthcare Industry Foundation (WBL) 
  • Saint Louis Area Health Lawyers Association
  • Member of Board of Advisors, Pink Ribbon Girls 
  • South Asian Bar Association of Metropolitan St. Louis, Board Member
  • South Asian Bar Association of North America
  • Gujarati
  • Hindi