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Attorney Spotlight

How does Jordana Nelson's prior experience as a general counsel inform her work with firm clients? Read more>

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Experience Spotlight

The M&A Advisor Winner 2017The M&A Advisor announced the winners of the 16th Annual M&A Advisor Awards on Monday, November 13 at the 2017 M&A Advisor Awards. Bass, Berry & Sims was named a winner in the two categories related to the following deals:

M&A Deal of the Year (from $1B-$5B) – Acquisition of CLARCOR Inc. by Parker Hannifin Corporation

Corporate/Strategic Deal of the Year (over $1B) – Acquisition of BNC Bancorp by Pinnacle Financial Partners

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Thought Leadership

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Regulation A+

It seems that lately there has been a noticeable uptick in Regulation A+ activity, including several recent Reg A+ securities offerings where the stock now successfully trades on national exchanges. In light of this activity, we have published a set of FAQs about Regulation A+ securities offerings to help companies better understand this "mini-IPO" offering process, as well as pros and cons compared to a traditional underwritten IPO.

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Operating Room, Law360 Health Group of the Year

Managed Care Strategy & Disputes

Our Managed Care Team plays a unique and invaluable role in the healthcare industry. Many of the nation's largest healthcare law firms represent managed care companies in disputes with providers. In contrast, Bass, Berry & Sims primarily focuses on representing hospitals and other providers in their dealings with managed care companies and other payors.

We represent the universe of healthcare providers, including hospitals and health systems, ambulatory surgery centers, air ambulance companies, dialysis companies, specialty pharmacies, clinical laboratories, physician practice management companies, and physician practice groups.

The passage of the Affordable Care Act has affected all stakeholders in the healthcare industry – patients, providers, and payors. Given the finite resources and infinite demands on the healthcare system, payors have become more aggressive by creating narrow networks, taking hard positions in contract negotiations, adopting restrictive claims handling policies and procedures, and raising premiums, all while lowering payments to providers. In this environment, it is critical to understand every aspect of the healthcare provider's contractual and non-contractual relationships with managed care companies, as well as the laws that affect these relationships. Maintaining a viable business model may depend on having a clear understanding of these issues and a supporting business and legal strategy.

Invariably, disputes will arise. No matter the type of managed care dispute, we successfully navigate these disputes and aggressively negotiate, arbitrate, and litigate on our client's behalf.

The scope of our Managed Care practice includes:

  • Contract strategy and negotiation
  • Public relations strategies for communications with patients, employers, physicians, and media
  • Contract interpretation and disputes
  • UCR disputes
  • Out-of-network strategies and disputes
  • Responses to attempted recoupments and offsets
  • Analysis of laws affecting managed care matters, such as ERISA, prompt pay laws, any willing provider laws, and the Affordable Care Act

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