Managed Care

Benesch has significant experience in the managed care industry. Benesch structured the earliest health maintenance organizations in Ohio and has been active in the industry ever since. In recent years, there has been a proliferation and consolidation of preferred provider organizations in response to the nation’s need for affordable health care. After representing various health care providers for many years, it was only natural that Benesch would move to the forefront in representation of preferred provider organizations as they came into existence.

Benesch’s preferred provider organization representation ranges from a statewide physician network for a national insurer to the purchase of a large, nationwide preferred provider network of hospitals and other health care providers. Recently, Benesch was involved in the acquisition and consolidation of the largest preferred provider network in the country. The acquisition occurred in multiple stages as the purchaser’s equity investment was used to expand the target network through the acquisition of other large networks.

In connection with this and similar projects, Benesch advises on transaction structuring, transactional due diligence, and coordinating transaction arrangements with a variety of investors, sellers, lenders, and regulatory agencies. Benesch’s participation with a client goes beyond transactional guidance. In addition to forming entities and negotiating transaction documents, Benesch assists its clients in navigating regulatory requirements and in strategic planning, thereby allowing our clients to identify and take advantage of opportunities for growth.

The multitude of legal requirements applicable to preferred provider organizations and network access providers often requires that counsel be able to act quickly in dealing with agencies and governmental representatives in multiple states. This is where Benesch excels. Utilizing knowledge of insurance regulations, prompt pay laws, and the tendencies of governmental agencies, Benesch has a long track record of meeting client expectations when it comes to negotiating obstacles to transactions in this heavily regulated industry. As a result, Benesch has developed a reputation among preferred provider organizations and network access providers as the firm that gets the deal done and gets it done right.