The firm hosted a webinar on September 29th.
As health care costs continue to rise, more employers are transitioning to self-funded health plans. This webinar explored the importance of successfully negotiating the terms of a third-party administrator (TPA) agreement, including key considerations for containing costs and ensuring appropriate legal protections.
Mary Powell and Sarah Kanter examined key contractual provisions and offer practical guidance on the following topics:
- The Independent Dispute Resolution (IDR) process and its impact on plan costs, including contractual strategies for mitigation
- “Shared Savings” fee arrangements: understanding the mechanics and limiting exposure
- Identifying and addressing ancillary fees, including prepayment integrity fees and overpayment recovery charges
- Medical rebate provisions: ensuring proper allocation and transparency in TPA reporting
- Performance guarantees: evaluating whether metrics are meaningful
- Additional critical provisions, including artificial intelligence safeguards, data access rights, limitation of liability, and indemnification clauses
