Law Commons^™

Legal Issues In Creating Ppo's, Douglas L. Elden, Richard A. Hinden

Journal of Law and Health

The development of alternate health care delivery and reimbursement mechanisms, particularly those known as "Preferred Provider Organizations" (PPOs), raise a multitude of legal issues. Each PPO will exist in different market conditions and under different state laws. Therefore, while this Article seeks to identify and discuss the legal issues, it cannot provide definitive answers. This Article can, however, serve as a guideline or checklist for PPO analysis and provide recommendations and alternatives for dealing with the legal roadblocks that occur in the formation and operation of PPOs. This discussion will be general in nature and cannot substitute for legal advice …