What federal law influences how healthcare insurance contracts are structured, especially regarding patient privacy and claims submission?
HIPAA (Health Insurance Portability and Accountability Act).
What is a subcontractor in the context of healthcare services?
A third party contracted to perform specific services under the primary contract’s scope, such as diagnostic testing or billing.
What does a non-solicitation clause generally prohibit in healthcare contracts?
It prevents parties from recruiting or hiring employees or clients from the other party.
In healthcare contracts, what is the term used to describe the maximum amount an insurer will pay for a covered service?
Allowable amount (or contracted rate)
Why is indemnification a critical clause in subcontracting within healthcare?
It shifts liability from the primary contractor to the subcontractor in case of malpractice or service errors.
How does a non-solicitation clause differ from a non-compete in the healthcare industry?
Non-solicitation prevents poaching of staff or clients, while non-compete restricts professional practice within a geographical area or time frame.
In provider contracts, what is typically the minimum required amount for general liability coverage?
What is $1 million per occurrence and $3 million aggregate?
What is one key risk of allowing unrestricted subcontracting in healthcare contracts?
What is the loss of quality control or regulatory compliance over subcontracted services?
What must a non-solicitation clause include to be enforceable under contract law?
What is a reasonable scope, duration, and geographic limitation consistent with public policy and state law?