Stephen Cowherd Quoted in South Florida Sun-Sentinel on Contract Disputes Between Hospitals and Insurers

Pullman & Comley Health Care Attorney Stephen M. Cowherd was quoted in the South Florida Sun-Sentinel article, “Your Health Insurer Is Now Out-of-Network at Nearby Hospitals. What Are Your Options?” In the article, Steve explains the legal requirements for notifying patients when a hospital or physician may go out-of-network, noting, “There has to be enough advance notice so patients are able to guide their healthcare decisions accordingly.” He clarified that government plans like Medicare require 45 days’ notice, while commercial plans must provide 30 days, giving patients time to adjust their care or make alternative arrangements.

On the topic of contracts between health systems and insurance companies, Steve said that most often, the health system and insurance company eventually agree on a new contract, although it may take time. “We typically see a three-year agreement with cost increases tied to increases in the consumer index for health care or some other metric,” he said. He also discussed how changes in network status might allow patients to switch plans, depending on the insurance type, explaining patients’ options for coverage.

To read the full article, please click here.