Addressing Disputes among Contracted Providers and Payors

May 16, 2019 11:45am

Rania M. Basha
Senior Legal Counsel
Humana (Louisville, KY)

Michael W. Lieberman
Crowell & Moring (Washington, DC)

Jon Rose
Senior Litigation Counsel
HCA (Nashville, TN)

  • As payment methodology moves toward “pay-for-performance” type of an arrangement, how can payments to providers be determined without it turning into a litigation issue?
    • How to reimburse individual providers and have enough transparency where providers believe that it is fair and complying with the contract
    • If there can be no transparency, what are the strategies for most efficient resolution of these disputes?
  • Best strategies for handling disputes in an arbitration context