What’s in a name? There is considerable overlap in the nature and goals of the “alphabet soup” of network structures—Accountable Care Organizations (ACOs), Independent Practice Associations (IPAs), Clinically Integrated Networks (CINs) and Physician Hospital Organizations (PHOs). Often, there is little difference among the network types, regardless of the latest popular acronym chosen as the label. They all present similar legal challenges to establishing, structuring and operating a successful provider network.
In a new webinar, Manatt decodes the acronyms—and explains, for both lawyers and nonlawyers, how to navigate the legal issues involved in launching and maintaining a provider network. Key questions the program answers include:
- Does a CIN differ significantly from an IPA, an ACO or a PHO—and if so, how?
- What is needed for a network to negotiate or contract collectively with payers?
- Are some network types authorized to undertake more advanced contracting initiatives than others?
- How can a network protect its contracts with payers beyond just the protections it receives for contracting with the Centers for Medicare & Medicaid Services as a Medicare ACO?
- What is the current status of Department of Justice/Federal Trade Commission antitrust guidance on ACOs and other joint contracting structures?
- Does the name or legal intentions of the entity have legal significance under antitrust law?
- How do state laws figure in the legal equation?
- Are messenger models limited to one entity type but prohibited from others?
Presenters:
Lisl Dunlop, Partner and Co-chair, Antitrust and Competition
David Oakley, Counsel, Manatt Health