You don’t need to be an employment lawyer to understand what a contract means when it says that a party can be terminated without cause or that a contract does not need to be renewed at the end of its term. But even employment lawyers might be surprised to learn that certain contracts with these provisions may not be so easily terminated or not renewed, especially involving doctors and other health-care providers such as under the Medicare Advantage regulations. 42 C.F.R. Sec. 422.202.
Since 1997, the federal government has allowed approved insurance companies to offer private Medicare and Medicaid coverage. In fact, today “Medicare Advantage” (MA), also known as “Part C,” insures over 20 million Americans, or one-in-three Medicare beneficiaries. If one joins a Medicare Advantage Plan, the insured obtains Medicare Part A (hospital insurance) and Part B (medical insurance) from the insurance company. The government pays a fixed amount each month to the company offering the coverage, and these insurance companies must follow Medicare’s coverage rules.
