tor to pay for a health plan’s lawyers, judgment, and court costs if a doc- tor and a managed care company get roped into a lawsuit together. “Those are often not covered by [medical li- ability insurance] policies and may actually come out of the doctor’s own pocket,” Mr. Stern warned. And if physicians ever want to get out of a contract, “it needs to be quick and seamless. I have seen terms that re- quire 180 days’ notice or even a year, and the doctor has to continue to see [the health plan’s] patients in the in- terim. Those are things that are not appropriate. A 30-day notice should be sufficient.” Mr. Reiner also cautions too many
requests for changes in contract lan- guage can unnecessarily delay ne- gotiations. To avoid such pitfalls, he suggests physicians weigh “the risk of those things actually happening, and sometimes the risk is not worth the time and effort to try to change the language. Or a lot of times it can back- fire, and you don’t get the change you wanted and you’ve wasted six to eight weeks.”
Beyond payment and legal terms,
Dr. Curran also likes to make sure his patients aren’t hassled when it comes to access to care, ensuring local hos- pital, imaging, and other critical ser- vices are available in the plan network, “so they are not having to drive 100 miles to have something done.”
PASSION AND PERSISTENCE Whatever the terms, physicians and legal experts say doctors themselves must have a hand somewhere in the contract negotiation process. Accord- ing to TMA’s survey, 52 percent of physicians were not involved, while 44 percent participated in some way, whether as primary decisionmaker or among a group of decisionmakers. Dr. Curran’s forte is wheeling and
dealing at the negotiating table. His practice partner, on the other hand, prefers to dig into the contracts, re- searching and reviewing them with another staff member, picking out
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