King & Spalding regularly represents clients in the dynamic interface between payors and providers that shapes our system of healthcare. Our lawyers counsel health systems on the development of managed care contracting strategies that help hospitals and affiliated physicians to achieve recognition of their bargaining power in payment and other key terms they negotiate with payors.
King & Spalding represents clients in the design and formation of multi-provider networks. Our healthcare antitrust specialists give sophisticated structuring and implementation advice to facilitate joint contracting by competing providers consistent with antitrust laws.
Whether it is Accountable Care Organizations, clinically integrated networks, payor/provider sponsorsed narrow networks of providers, or other innovative structures, our lawyers understand the myriad care delivery relationships that have emerged in recent years, the legal constraints applicable to these relationships, and the financial and performance metrics that are aligned with success. Our deep familiarity with complex and specialized managed care legal issues, such as ERISA preemption, allows us to affect the payor-provider dynamic in a way that provides substantial benefit for our clients.
Lawyers in the Managed Care Practice include individuals with significant industry and regulatory experience. This type of experience provides valuable hands-on insight into this highly specialized area of law. Our Managed Care Practice includes:
- Two past presidents and a current director of the American Health Lawyers Association.
- The immediate past chair of the Healthcare Liability and Litigation Practice Group of the American Health Lawyers Association.
- A former Assistant General Counsel of a major health insurer and co-editor of the Health Plans Contracting Handbook published by the American Health Lawyers Association.
- The current president of the Health Care Compliance Association (HCCA).