47th Annual Lawyers’ Conference: Health Plan Success in the Post-ACA World; New Models of Provider and Vendor Contracting
Linda Tiano, Member of the Firm, will speak at the 47th Annual Lawyers' Conference, which runs from October 28 to 30.
On October 28, at 10:00 a.m., Ms. Tiano presents "Health Plan Success in the Post-ACA World: New Business and Revenue Opportunities." She will review the limitations on profitability under the MLR, premium rate increase restrictions and other rules imposed by the ACA, and then explore the new product lines and ventures that health plans can and are engaging in to improve their long term financial health and growth opportunities, such as provider and ACO management agreements, ventures to create health related IT programs, and devices that can be marketed to a wide range of consumers and telehealth ventures. Ms. Tiano will also address legal constraints and issues that should be considered when analyzing these opportunities, such as fraud and abuse, antitrust and tax related issues.
On October 29, at 2:45 p.m., Ms. Tiano presents "New Models of Provider and Vendor Contracting: The Pluses and the Perils." She will review emerging trends relating to agreements between health plans and provider groups and third party vendors, including expanded and creative risk sharing and population management programs, joint ventures, and other arrangements. The session will then explore the myriad legal issues that these new arrangements may implicate, including corporate practice and fee-splitting issues, fraud and abuse issues, issues relating to network licensure and issues relating to the calculation of medical loss ratios under PPACA, including those raised in the recent lawsuit MRI Scan Center v. National Imaging Associates, et al.
For more information, visit the conference website.