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Our Managed Care Organizations Practice specializes in identifying the inherent exposures to loss of managed care organizations and addressing them based on the specific needs of the individual organization. In addition to the traditional exposures faced by any commercial organization (property, general third party liability, Workers’ Compensation, crime, etc.), some of the unique exposures your organization may face include the following:
Managed Care Errors and Omissions
• Vicarious Liability
• Interference Torts
• Denial of Benefits
• Anti-trust Claims
• Class Action Claims
• Peer Review/Credentialing Exposures
Directors and Officers Liability, including Employment Practices
We will conduct a complete audit of your existing policies and procedures that includes reviewing Articles of Organization, By-Laws, Employee Handbooks, Privacy Agreements, and Relationships of Directors/Officers in Outside Organizations so that working together with you, we can determine your organization’s exposure to risk. This comprehensive approach enables us to make sound, cost-effective risk management recommendations that often times includes meeting with the Board of Directors to discuss particular areas of concern.
Provider Excess of Loss Reinsurance
Because we are experienced in the specialized field of Provider Excess of Loss Reinsurance we represent time-tested and stable insurance carriers to provide required coverage. Our risk analysis will help to determine the proper attachment point ensuring that your organization does not end up “trading dollars” with the carrier.
An important part of this coverage is the “continuation of coverage” or “insolvency” addendum. Given the probability of potential cuts in the Medicare/Medicaid programs on a federal level, the importance of such coverage cannot be overstated.
We work with carriers and MCOs to tailor transplant network needs as well as case management requirements on an individual basis.
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