Managed Care & Provider-Payer Relations
In dealing with managed care matters and the relationships between healthcare providers and private payers, Squire Sanders lawyers have experience assisting provider clients in a broad range of issues including contract negotiations, network formation, healthcare antitrust, compliance, mergers and acquisitions, billing and claims processing, credentialing and termination disputes, and advising providers on the complex issues surrounding financially troubled or insolvent payers.
Examples of our experience include:
- Providing assistance in the creation of a managed care physician networks.
- Assisting in the creation of a network of long-term care facilities throughout the country.
- Working through all issues in the merger of physician-hospital organizations.
- Analyzing hundreds of managed care contracts of all major and minor health plans and networks.
- Analyzing innovative strategies including clinical integration strategies for healthcare joint ventures.
- Providing legislative counseling for providers on managed care and mandate issues, including the Federal Patient Bill of Rights and many state law issues.
- Assisting providers in petitioning health plans to reimburse for new technologies or procedures.