Health - Insurance
HEALTH BENEFIT PLANS ~ In combination with our Health Department, we provide counsel to health insurers with regard to the myriad of regulatory and compliance requirements to which the industry is subject. Our experience includes handling state attorney general investigations, inquiries pertaining to market conduct, compliance with financial standards, provider relationships, and the implementation of guarantees of renewability and portability. Additionally, we advise and assist clients in addressing state and federal rate and premium filings. In addition to insured benefit programs, we have extensive experience working with self-insured plans and third party administrators.
MANAGED CARE ~ Our Managed Care Practice Group experience includes state regulatory compliance; not-for-profit conversions; corporate restructurings, acquisitions and merger; negotiating management and delegation agreements; interpreting state anti-managed care laws (e.g., AWP requirements); establishing point-of-service products; advising on ERISA requirements; consulting on peer review immunity under the Health Care Quality Improvement Act; handling provider termination proceedings and contract litigation; bankruptcy and rehabilitation; and accreditation procedures. We have extensive experience in handling all aspects of federal and state government contracting with managed care plans. We work with Medicare+Choice, Medicaid, Federal Employees Health Benefit Program and Tricare contractors. Among other matters, we are experienced in preparing bid responses and bid protests in competitive procurements; state waiver and demonstration project requests; provider contracting; marketing compliance; appeals and grievance procedures; federal pre-emption; applicability of fraud and abuse and self-referral laws; and privacy and confidentiality.
Contacts
- Gary Scott Davis
+1 305 347 6520
Send E-mail - J. Peter Rich
+1 310 551 9310
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