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Government and Commercial Contracting

The Centers for Medicare and Medicaid Services (CMS) has standard contracts which it uses to engage facilities, group practices, physician practitioners (PP) and nonphysician practitioners (NPP) which are generally non-negotiable. Commercial carriers also offer “non-negotiable” contracts which become negotiable if you are a large provider or you offer a unique service. Whenever you enter a contract for services – negotiable or non-negotiable – it is important to understand the terms and conditions for what you obligate yourself or your practice including restrictive covenants (non-compete and non-solicitation provisions), licensing, credentialing, and other similar provisions.

Medicaid Managed Care agreements and Medicare Advantage plans while incorporating CMS’ standard contracts include many provisions that are non-standard and potential stumbling blocks. Commercial carriers include language that is contrary to Florida Law or included in the contract to specifically circumvent provisions in the Law (for example, under Florida Law offset is permissible if agreed to in writing).

The firm handles all areas of contracting including drafting, negotiation, and explanation so that you and your practice are confident in your decision to render services under a specific agreement.

Karen B. Schapira, PLLC