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Payers, Plans, and Managed Care

 
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The Payers, Plans, and Managed Care Practice Group addresses all legal issues concerning health plans and insurers, including but not limited to plan operations and management, managed care, litigation, regulations, privacy, and security.

 

Payers, Plans, and Managed Care Practice Group Bill of Sale

Summaries of the Office of Inspector General (OIG) Advisory Opinions are provided by the Advisory Opinions Task Force of the Fraud and Abuse Practice Group. The Task Force aids Practice Group members in keeping abreast of new Advisory Opinions. For each new opinion issued by the OIG, a summary is released via an email alert and posted on several Practice Groups'websites.

​DHHS OIG Advisory Opinions

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Member Briefings, prepared by members of Practice Groups, are a useful practice tool to facilitate your understanding of the most recent health law issues and to assist you and your clients with implementing those issues.

You may access this content by joining AHLA and enrolling in Payers, Plans, and Managed Care Practice Group.


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You may access this content by enrolling in Payers, Plans, and Managed Care Practice Group.

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Executive Summaries, prepared by members of Practice Groups, are a useful practice tool to facilitate your understanding of the most recent health law issues as they develop.

You may access this content by joining AHLA and enrolling in Payers, Plans, and Managed Care Practice Group.


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You may access this content by enrolling in Payers, Plans, and Managed Care Practice Group.

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Newsletters offer articles on the most recent issues facing health law attorneys within their practice area. They also provide news of recent Practice Group events and highlight opportunities to get involved in the Association.

Interested in writing an article? Please submit your article proposal to the Practice Groups staff including the title/topic and a short summary, and indicate which Practice Group(s) you would like to submit it to.

The following toolkits are made available to members of the Payers, Plans, and Managed Care Practice Group (PPMC PG). If you have any comments or suggestions on existing or potential toolkits, please email the PPMC PG leadership.

Emergency Preparedness Toolkit
Published on May 4, 2010
 
Medicare Advantage and Part D Preemption 
Published on February 25, 2010
 
Managed Care Contracting Toolkit 
Published on June 22, 2009

You may access this content by joining AHLA and enrolling in Payers, Plans, and Managed Care Practice Group.


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You may access this content by enrolling in Payers, Plans, and Managed Care Practice Group.

You may access this content by Renewing your membership for Payers, Plans, and Managed Care

Health Plan Management System Memoranda Document Library
This document library contains Part D guidance materials distributed to plans by the Health Plan Management System (HPMS).

You may access this content by joining AHLA and enrolling in Payers, Plans, and Managed Care Practice Group.


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You may access this content by enrolling in Payers, Plans, and Managed Care Practice Group.

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Upcoming:

Past:

July 16, 2015 2:00 PM-3:30 PM Eastern
July 14, 2015 2:00 PM-3:30 PM Eastern
July 9, 2015 2:00 PM-3:30 PM Eastern
June 25, 2015 2:00 PM-3:30 PM Eastern

Upcoming:

Past:

WEDNESDAY, JANUARY 14, 2015

Upcoming:

Past:

July 1, 2015 12:30 PM-1:45 PM Eastern
June 30, 2015 12:30 PM-1:45 PM Eastern
June 29, 2015 12:30 PM-1:45 PM Eastern
April 16, 2015 12:00 PM-1:15 PM Eastern
March 26, 2015 12:15 PM-1:35 PM Eastern

​Affinity Groups

Affinity Groups are created to facilitate networking and educational opportunities with other Practice Group members who share similar professional interests.
Please note: You must be a member of Payers, Plans, and Managed Care Practice Group or a government, academician, student, or PG 15 member (all-Practice Groups access) to enroll in these Affinity Groups.

Task Forces

Task Forces are established for those health law topics that cross over several Practice Groups, and they provide collaborative, substantive resources for the benefit of the sponsoring Practice Groups' members.
Please note: You must be a member of the Payers, Plans, and Managed Care Practice Group or one of the other sponsoring Practice Groups to receive benefits produced by these Task Forces.
  • Accountable Care Organization Task Force
    The Accountable Care Organization (ACO) Task Force monitors and evaluates the implementing statutes, regulations, cases, and secondary materials concerning ACOs. It provides written materials, webinars, and in-person educational activities to assist AHLA's members to implement ACOs and comply with ACO laws and rules. Since the ACO subject matter is so broad, and impacts the missions and interests of so many Practice Groups, the ACO Task Force is a multi-disciplinary/multi-group entity, and focuses its efforts on the production of a coherent and effective line of ACO-related educational materials using a variety of media and employing AHLA’s vast resources.
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  • Behavioral Health Task Force
    The Behavioral Health (BH) Task Force is committed to advancing the understanding of laws impacting behavioral health, including the delivery of services to those living with mental illness, certain neurological conditions, substance use disorders or developmental disabilities, and reimbursement for such services. A complex framework of federal and state laws concerning privacy, information sharing and exchange, reimbursement, involuntary commitment, and other subjects provides unique challenges to health care providers and payers of behavioral health services. Scientific, legislative, and other developments, including health care reform, have presented new issues and opportunities in this area, including primary and behavioral health care integration initiatives, insurance coverage parity mandates, changes to Medicaid, and evolving public policy, to name a few. The BH Task Force monitors and evaluates these laws and developments through written materials, webinars, and in-person educational activities so that AHLA members are better equipped to advise clients on behavioral health topics. In addition, the work of the BH Task Force serves to raise awareness about how behavioral health laws influence health improvement efforts, and will include collaborative efforts with AHLA's Public Interest activities.
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  • Health Care Reform Educational Task Force
    The Health Care Reform Educational Task Force serves as a single key point-of-contact for the Association membership for institutional resources regarding comprehensive health care reform initiatives at the state and federal levels. The Task Force works to educate AHLA members on proposed health care reform initiatives as well as report on ongoing experiences with recently enacted reform initiatives.

  • Webinars

    Roundtable Discussions


    LeadershipView Project Reports

    Image of JeremyEarl
    Jeremy Earl Social Media Coordinator McDermott Will & Emery LLP Washington, DC (202) 756-8189 Email
    Image of MarkKopson
    Mark S. Kopson Chair Plunkett Cooney PC Bloomfield Hills, MI (248) 901-4061 Email
    Image of XavierBaker
    Xavier Baker Vice Chair - Membership Crowell & Moring LLP Washington, DC (202) 624-2842 Email
    Image of RobertSlavkin
    Robert E. Slavkin Vice Chair - Publications Akerman LLP Orlando, FL (407) 419-8438 Email
    Image of LeahStewart
    Leah B. Stewart Vice Chair - Educational Programs Beatty Bangle Strama PC Austin, TX (512) 879-5059 Email
    Image of BrianStimson
    Brian Richard Stimson Vice Chair - Research & Website Alston & Bird LLP Atlanta, GA (404) 881-4972 Email
    Image of JaniceZiegler
    Janice H. Ziegler Vice Chair - Strategic Planning and Special Projects Dentons US LLP Washington, DC (202) 408-9158 Email

     

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