Neil M. Sullivan, Counsel  in the firm’s Healthcare and Corporate Departments, will be on the faculty for the webinar “Managed Care Contracts: Medicare and Medicaid Considerations for Providers,” to be presented by Strafford on Thursday, May 18, 2023 from 1:00pm – 2:30pm.

Over the past few years, the changes in healthcare have driven fundamental changes in the relationship between providers and managed care organizations (MCOs) and have introduced new approaches to managed care contract negotiations. Negotiating favorable rates and terms in this new environment is more challenging than ever.

Among the changes is the increasing shift to Medicare and Medicaid managed care. Many states are expanding Medicaid-managed care to contain healthcare costs and implement value-based payment initiatives. In addition, state Medicare populations are increasingly enrolling in Medicare Advantage.

Providers continue to grapple with reimbursement and new value-based payment arrangements, delegation, and addressing contract provisions required by Medicare, among other things. Counsel negotiating managed care contracts must carefully consider complex arrangements and anticipate potential areas of dispute. Counsel must also take steps to minimize potential exposure for the provider for nonperformance of obligations under the contract.

This program will address best practices for providers negotiating managed care contracts. With a focus on Medicare and Medicaid contracts, the panel will examine current trends in contract negotiations, key contract provisions, and ways to address common areas of dispute.

Topics to be addressed include:

• Managed care contracting: current legal trends
• Medicare and Medicaid managed care contracts
• Practical tips for negotiating key contract provisions
• How have the changes in healthcare and the shift to Medicare and Medicaid impacted the negotiation of managed care agreements?
• What are some proven approaches for providers' counsel in negotiating favorable provisions in managed care contracts?
• What are the most commonly disputed issues during contract negotiations and practical approaches for resolving them?

Mr. Sullivan concentrates his practice in healthcare and insurance law, with a particular emphasis on the intersection of healthcare finance and delivery. He regularly represents and counsels health plans and healthcare providers in regulatory compliance and filings, and alternative financial models for healthcare delivery, including Organized Delivery Systems (ODS), Accountable Care Organizations (ACO), Multiple Employer Welfare Arrangements (MEWA), and health system equity ownership or participation in insurance organizations.

Additional program details and registration are available on the Strafford website.