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PRACTICE AREAS

Managed Care

Athene Law attorneys are experienced in advising providers on all aspects of their relationships with managed care plans.  We understand the unique nuances of working with governmental managed care, such as Medicare Advantage and Medicaid managed care, as well as the broad range of commercial payors. We also understand integrated networks and provider alignment.

Our specific managed care services include:

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  • Review and negotiation of managed care contracts (including capitation contracts)

  • Review and negotiation of provider agreements with independent practice associations (IPAs)

  • Advice with respect to overall managed care strategy

  • Network participation disputes

  • Payment disputes (contract and non-contract)

  • Regulatory compliance with governmental managed care requirements

  • Communication strategy for out-of-network providers

  • Advice with respect to scope of obligations for Knox Keene risk-bearing organizations

  • Joint ventures between health plans and hospitals and other providers