Legal considerations in managed care contracting

Managed health care systems are created primarily through contracting. Although contracts with managed care organizations, such as health maintenance organizations, are often presented to providers as non-negotiable, this chapter discusses basic contract terms that are frequently negotiated by the parties, including key contract definitions, compensation, term and termination, and "boilerplate" provisions. The chapter also emphasizes the need for contracting parties to conduct precontracting due diligence and to comply with applicable antitrust laws in negotiating contracts with groups of independent providers.