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 video webinar with Q&A

This program is included with the Strafford CLE Pass. Click for more information.
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Conducted on Wednesday, March 2, 2022

Recorded event now available

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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.

Description

Over the past few years, the changes in healthcare have 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 implement 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.

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Outline

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

Benefits

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 practical approaches for resolving them?

Faculty

Barak Bassman
Barak Bassman

Partner
Blank Rome

Mr. Bassman focuses his corporate litigation practice on advising healthcare and other clients in both general trial...  |  Read More

Gross, Stephanie
Stephanie Gross

Attorney
Hooper Lundy & Bookman

Ms. Gross practices in the firm’s regulatory and business departments, where she assists health care providers,...  |  Read More

Sullivan, Neil
Neil M. Sullivan

Counsel
Greenbaum Rowe Smith & Davis

Mr. Sullivan concentrates his practice in healthcare and insurance law, with a particular emphasis on the intersection...  |  Read More

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