Managed Care Contracts: Medicare and Medicaid Considerations for Providers

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.

Changes in healthcare have fundamentally altered 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 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.