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      "text": "The medical air transport industry is high-risk and prone to billing fraud and kickbacks.",
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      "text": "U.S. Air Medical Provider Air Methods Files For Bankruptcy",
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      "text": "Air Medical Transport Company Agrees to Pay $1 Million to Resolve Allegations of False Claims Act Violations",
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      "text": "EV to product sales: 10X",
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      "text": "TransMedics is an airline with a medical device attached, at 7X LTM revenue, a lofty multiple even by speculative midcap metrics. The only relevant measure, of course, is EV to product sales, which at 10X – with those sales tanking sequentially – makes it the most expensive midcap medtech in the US, and 3rd priciest overall, after ISRG ($200B) and GKOS ($8B). Even at an absurd 5X multiple to product sales, the stock would be in the $30’s. The air charter and service half is worthless – a low multiple of book or EBITDA, typical of low-gross margin/high PP&E plays, with PE comps easily available. TransMedics capex is high at $158MM LTM, with net debt even if it liquidated its jets; has no free cash flow; ran losses until recently before becoming slightly profitable, which is likely to revert as sales decline. The medical air transport industry is high-risk and prone to billing fraud and kickbacks. Large players regularly succumb to DOJ investigations. Its competitors Trinity Air Medical and The Nationwide Organ Recovery Transport Alliance (NORA) allegedly engage in dubious practices, and are allegedly under investigation, as we shall cover. Air Methods, owned by private equity, settled with the DOJ in 2023, filing for bankruptcy a few months later after they blew up its business model.",
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      "text": "Source: Scorpion Capital consultation calls with experts; https://www.justice.gov/usao-edky/pr/air-medical-transport-company-agrees-pay-1-million-resolve-allegations-false-claims; https://aviationweek.com/business-aviation/aircraft-propulsion/us-air-medical-provider-air-methods-files-bankruptcy",
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      "text": "Air medical transportation – industry articles",
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