Managed Care Networks:
Managed Care Contracting:
A good source for practical information an analysis of managed care contracting issues is the Model Managed Care Agreement drafted by the AMA.
As the Managed Care Contracting problem illustrates, insurers
ask physicians to sign contracts that have "blind" payment terms in
physicians agree to fee schedules that not only are subject to
but also that the company keeps secret, even from the contracting
Regarding this practice, one court held that unilateral changes in fee
schedules are permissible, but not secret fee schedules, since
physicians have no way to determine if they've been paid the correct
Medical Assoc. of Georgia v. Blue Cross and Blue Shield of Georgia, 536
S.E.2d 184 (Ga. App. 2000).
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