Managed Care & Insurance

    The Managed Care & Insurance Interest Group serves as a resource to attorneys who represent or regulate entities and/or individuals doing business in the managed care industry. An emphasis is placed on tracking federal and state laws and regulations as well as market trends. Specific areas of focus include managed care liability; ongoing statutory and regulatory reforms; balance billing and out-of-network issues; insolvency issues affecting the organized delivery of care; contracting strategies and innovations; the changing status of health care delivery and reimbursement; restructuring and management of risk-sharing arrangements; and new products offered by payors and employers; payor/provider relationships; and new policies or issues affecting managed care, such as network tiering, valued-based purchasing, bundled payments and ACOs.

    Managed Care Litigation Update® ("MCLU")

    Are you struggling to stay on top of new case filings and trends in managed care litigation? Then consider subscribing to Managed Care Litigation Update® ("MCLU"), a new product being offered by the Health Law Section for 20% off of the list price. MCLU is a bi-weekly, e-publication that summarizes federal court filings involving managed care disputes between patients and providers versus payors. It is a ready resource to track trends, follow particular insurer/provider controversies, and observe industry developments from a high level, aiding in the assessment of litigation and/or underwriting risk. Each quarter-ending issue contains key statistics on cases filed during the quarter, enabling subscribers to see where cases are being filed, the types of cases being filed, and which major health insurers are involved.

    MCLU is authored by Jonathan M. Herman, Herman Law Firm, Dallas, TX.

    To learn more about MCLU or subscribe - Click Here

    May 5, 2020 - Managed Care Updates Related to COVID 19

    This webinar covered a wide range of topics including anticipating COVID related reimbursement disputes, additional litigation concerns related to COVID, immunity for COVID related activities, MRA/MLR issues, Telemedicine, the FFCRA requirements for COVID-19 coverage and the requirement for providers that have accepted Provider Relief Funds are required to treat patients as in-network.

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    January 14, 2020 - SURPRISE! A Look at the Hottest Topic in Health Care 2020 - Network Adequacy and Surprise Billing

    Panelists examined network adequacy requirements at the state and federal level; provided a background of the current impasse; reviewed present legislative proposals; looked at provider directory requirements and enforcement efforts; and offered payor and provider insights about the best path forward.

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    October 27, 2016 - Real World Obstacles When Moving from Volume to Value

    There is an unstoppable movement towards value based reimbursement, but truly transitioning from volume to value is an uphill battle. Panelists discussed real world legal and regulatory obstacles as well as value based reimbursement in civil disputes, examples of arrangements that did not end amicably, and how to unwind and resolve deals that do not go as planned.

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