Kevin Malone, Member of the Firm, co-presents a webinar, “Negotiating Managed Care Agreements with Health Plans: Key Provisions, Anticipating Areas of Dispute, Court Treatment,” hosted by Strafford.
The past two years have brought many changes to the health care industry, impacting the relationship between providers and health plans. Negotiating favorable rates and terms in the new environment is more challenging than ever.
Recent litigation serves as a good reminder about the importance of negotiating managed care contracts, which govern the cost and quality of health care services between providers and patients. A recent decision from the California Court of Appeal, San Jose Neurospine v. Aetna Health of California (2020), held a miscoded bill was not a proper basis for the health plan to avoid payment. The court rejected the plan’s argument that the provider’s technical error precluded the provider from obtaining payment. It is important to anticipate potential areas of dispute when negotiating the managed care agreement, including the resolution of technical errors.
Counsel should carefully consider complex arrangements and take steps to reduce potential exposure for the provider of nonperformance of obligations under the agreement.
Kevin and others discuss negotiating managed care agreements with health plans. The panel offers best practices for providers, examine current trends in contract negotiations, and discuss recent court treatment, key contract provisions, and ways to address common areas of dispute.
For more information, please visit StraffordPub.com.