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 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.
- Managed care contracting: current legal trends
- Medicare and Medicaid managed care contracts
- 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 practical approaches for resolving them?
Mr. Bassman focuses his corporate litigation practice on advising healthcare and other clients in both general trial... | Read More
Mr. Bassman focuses his corporate litigation practice on advising healthcare and other clients in both general trial and dispute resolution as well as antitrust litigation and counseling. He has significant experience serving as lead counsel in litigation across the U.S., resolving complex matters as efficiently as possible in his representation of healthcare providers, third-party payors, and life sciences companies in payment disputes, antitrust issues, managed care contract negotiations, and termination and regulatory challenges. Mr. Bassman has also represented many clients outside of healthcare in antitrust litigation and counseling.Close
Hooper Lundy & Bookman
Ms. Gross practices in the firm’s regulatory and business departments, where she assists health care providers,... | Read More
Ms. Gross practices in the firm’s regulatory and business departments, where she assists health care providers, including hospitals, physicians, and health services companies with a broad range of corporate, transactional, compliance, and reimbursement issues. Prior to attending law school, Ms. Gross served as a program analyst with the Center for Consumer Information and Insurance Oversight within the Centers for Medicare & Medicaid Services. In that role, Ms. Gross was responsible for drafting portions of the first regulations establishing the Affordable Care Act’s health insurance exchanges and played a lead role in operationalizing the health plan certification process.Close
Neil M. Sullivan
Greenbaum Rowe Smith & Davis
Mr. Sullivan concentrates his practice in healthcare and insurance law, with a particular emphasis on the intersection... | Read More
Mr. Sullivan concentrates his practice in healthcare and insurance law, with a particular emphasis on the intersection of healthcare finance and delivery. He regularly represents and counsels health plans and healthcare providers in regulatory compliance and filings, and alternative financial models for healthcare delivery, including Organized Delivery Systems, Accountable Care Organizations, Multiple Employer Welfare Arrangements, and health system equity ownership or participation in insurance organizations. As Assistant Commissioner of the New Jersey Department of Banking and Insurance from 2010-2014, Mr. Sullivan oversaw the Office of Life and Health during a period of fundamental change in both the healthcare and insurance sectors. This encompassed the implementation of the Affordable Care Act and the Dodd-Frank Wall Street Reform and Consumer Protection Act; the emergence of alternative financial models for health care delivery, including CO-OPs, ACOs, and health system equity ownership or participation in insurance organizations; and the transition to electronic health records and implementation of the ICD-10 mandate.Close