Managed Care Contracts: Medicare and Medicaid Considerations for Providers

Reimbursement and Delegation Challenges, Key Provisions and Anticipating Areas of Dispute

Recording of a 90-minute CLE webinar with Q&A

Conducted on Wednesday, March 20, 2019

Recorded event now available

or call 1-800-926-7926
Course Materials

This CLE course will provide healthcare counsel with a roadmap for drafting and negotiating managed care contracts on behalf of providers. With a focus on Medicare and Medicaid contracts, the panel will discuss current trends in contract negotiations, critical provisions in the agreements and strategies for resolving common areas of dispute.


The changes in healthcare over the past few years has driven fundamental changes in the relationship between providers and MCOs and introduced new approaches to managed care contract negotiations. Negotiating favorable rates and terms in this new environment is more challenging than ever.

Among the changes is the increasing shift to Medicare and Medicaid managed care. Many states are expanding Medicaid managed care to contain healthcare costs and implementing value based payment initiatives. In addition, state Medicare populations are increasingly enrolling in Medicare Advantage.

Providers continue to grapple with reimbursement and new value based payment arrangements, delegation, and addressing contract provisions required by Medicare, among other things. Counsel negotiating managed care contracts must carefully consider complex arrangements and anticipate potential areas of dispute. Counsel must also take steps to minimize potential exposure for the provider for nonperformance of obligations under the contract.

Listen as our authoritative panel of healthcare attorneys offers best practices for providers negotiating managed care contracts. With a focus on Medicare and Medicaid contracts, the panel will examine current trends in contract negotiations, key contract provisions and ways to address common areas of dispute.



  1. Managed care contracting—current legal trends
  2. Medicare and Medicaid managed care contracts
  3. Practical tips for negotiating key contract provisions


The panel will review these and other essential questions:

  • How have the changes in healthcare and the shift to Medicare and Medicaid impacted the negotiation of managed care agreements?
  • What are some proven approaches for providers' counsel in negotiating favorable provisions in managed care contracts?
  • What are the most commonly disputed issues during contract negotiations and what are some practical approaches for resolving them?


Barnes, Clifford
Clifford E. Barnes

Epstein Becker & Green

Mr. Barnes is Co-Chair of the firm's Health Plan Compliance Group. He has been employed by the firm for over 35...  |  Read More

Puff, Christian
Christian Puff

Hall Render Killian Heath & Lyman

Ms. Puff works most frequently with provider groups and health systems as well as provider-owned plans. She regularly...  |  Read More

Access Anytime, Anywhere

Strafford will process CLE credit for one person on each recording. All formats include course handouts.

To find out which recorded format will provide the best CLE option, select your state:

CLE On-Demand Video