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
LEXINGTON, Ky.—Leadership Kentucky recently selected Stites & Harbison, PLLC attorney Dustyn Jones as one of 25 participants for the Elevate Kentucky Class of 2019.
LOUISVILLE, Ky.—The 2019 edition of Kentucky Super Lawyers recently honored 42 Stites & Harbison, PLLC attorneys in the Covington, Frankfort, Lexington and Louisville, Ky., offices. The publication named 33 attorneys to the Super Lawyers list and nine attorneys to the Rising Stars list.
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Presented by UK Law Continuing Legal Education in partnership with the Kentucky Bar Association Health Law Section and Kentucky Academy of Hospital Attorneys