Health Insurance & Managed Care
Managed care continues to have a tremendous impact on health care. Our health law practitioners provide a full range of services related to managed care arrangements including all aspects of HMO and PPO development, acquisition and sale, managed care joint ventures, independent practice associations (IPAs), and physician-hospital organizations (PHOs).
Our services include:
- Determination of appropriate structures and business forms
- Preparation of contracts with providers and payors
- Preparation of contracts with Medicare and federal employees
- Review of fraud and abuse, Stark, and reimbursement issues
- Insurance regulatory compliance and other state department of insurance matters
- Securities exemptions, offerings and registration matters
- Drafting and negotiating managed care contracts (e.g., Preferred Provider Arrangements, Participating Provider Agreements, Network Access Agreements, etc.)
- Form filings with state departments of insurance
- Administrative proceedings before state departments of insurance
- Development of internal policies and procedures for HMOs, PPOs, and other health insurers (e.g., utilization review, internal appeal and grievance procedures, etc.)
- Counsel on federal regulatory law impacting health insurance and managed care (e.g., HIPAA, ERISA, COBRA and Medicare Part D)
- Representing managed care clients in mergers and acquisitions
Stites & Harbison Promotes Three Attorneys
LOUISVILLE, Ky.—Stites & Harbison, PLLC announced today that three attorneys have been promoted within the law firm effective January 2021.
Joint Agency Cyber Alert Warns of Imminent and Credible Ransomware Threat Against U.S. Health Care and Public Health Sectors
A joint cybersecurity advisory alert issued October 28, 2020, warns of an imminent cybercrime threat to the U.S. health care sector.
Kentucky Health Law Institute
Time: 8:00 a.m. - 5:00 p.m.
WEBINAR (via Zoom)
Sarah Spurlock, Janet Craig and Dustyn Jones will be presenters at this WEBINAR presented by UK Law Continuing Legal Education on September 2-3, 2020.
Healthcare Fraud and Abuse Laws are Relaxed During COVID-19
In response to the global COVID-19 pandemic, on March 30, 2020, the Secretary of the Department of Health and Human Services (HHS) issued nationwide blanket waivers of sanctions under the federal physician self-referral law (Stark Law) for “COVID-19 Purposes” (Blanket Waivers).