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NC Medicaid Managed Care: Provider-Prepaid Health Plan Contract Issues and Potential for Disputes

11:55      Welcome and Introductions

12:00      NC Medicaid Managed Care: Provider-Prepaid Health Plan Contract Issues and Potential for Disputes

Marcus C. Hewitt, Fox Rothschild LLP, Raleigh

Review the timeline of the transition to and implementation of Medicaid Managed Care in North Carolina, and explore common issues in PHP-provider network contracting, and likely areas where providers may have difficulty. This presentation discusses a potential for PHP-provider disputes, dispute resolution, and factors that may influence disputes and PHP networks. Topics include rates, key contract terms, dispute resolution procedures, claim denials, member and provider appeals, and factors that may influence contracting and the resolution of disputes.

1:00        Adjourn

Thank you

Thank you for joining us for NC Medicaid Managed Care: Provider-Prepaid Health Plan Contract Issues and Potential for Disputes.

Contributors

  • Marcus C. Hewitt

    Marcus C. "Marc" Hewitt is a partner in the Raleigh office of Fox Rothschild and has practiced in the areas of health care and administrative litigation for almost 20 years. He works exclusively in the healthcare industry, advising clients on regulatory matters in transactions and operations, and representing them in disputes, including administrative and commercial litigation.

    Marc has followed North Carolina's Medicaid managed care program since 2015, and has worked with providers, prepaid health plans, and external quality review organizations in entity formation, network provider contracting, regulatory compliance, and protests and appeals from state contract awards.

    Marc also advises health systems and other providers on other state regulatory compliance and related issues before the North Carolina Department of Health and Human Services and Department of Insurance, including managed care, formation and compliance of HMO entities, joint ventures, certificate of need, licensure and others.

    Click here for more information about Marc.

November 17, 2021
Wed 11:55 AM EST

Duration 1H 5M

This live web event has ended.

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