Managed Care Networks:
On laws protecting physicians from deselection, see Linda C. Fentiman, Patient advocacy and termination from managed care organizations: Do state laws protecting health care professional advocacy make any difference?, 82 Neb. L. Rev. 508-574 (2003).
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 sometimes
ask physicians to sign contracts that have "blind" payment terms in which
physicians agree to fee schedules that not only are subject to change,
but also that the company keeps secret, even from the contracting parties.
Regarding this practice, one court held that unilateral changes in fee
schedules are permissible, but not secret fee schedules, since otherwise
physicians have no way to determine if they've been paid the correct amounts.
Medical Assoc. of Georgia v. Blue Cross and Blue Shield of Georgia, 536
S.E.2d 184 (Ga. App. 2000).
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