Insurance Regulatory

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
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Press Releases

Kelly White Bryant Promoted to Chair of Stites & Harbison’s Health Care Service Group

LOUISVILLE, Ky.—Stites & Harbison, PLLC is pleased to announce that attorney K. Kelly White Bryant has been promoted to Chair of the firm’s Health Care Service Group.

by Stites & Harbison, PLLC July 17, 2023
Press Releases

Stites & Harbison Earns National and Regional Top 10 Honors from ABA Health Law Section

LOUISVILLE, Ky.—The American Bar Association (ABA) Health Law Section has ranked Stites & Harbison, PLLC in its Tenth Annual Regional Top 10 Law Firm Recognition List of Top 10. The firm ranked 8th in the inaugural National Top 10 list and 4th in the South Top 10 list. Stites & Harbison has been honored nine consecutive times to the South list.

by Stites & Harbison, PLLC May 19, 2023
Events

Kentucky Hospital Association 94th Annual Convention

Date: 5/15/23 - 5/17/23

Central Bank Center, 430 W Vine Street, Lexington, Kentucky 40507

Stites & Harbison attorneys Sarah Spurlock, Ameena Khan and Shea Luna will be speakers at this year's Kentucky Hospital Association Convention in Lexington, Ky.

Sarah Cronan Spurlock, Ameena R. Khan, and Stacy Shea Luna (Shea) April 05, 2023