AHLA Health Plans Contracting Handbook: A Guide for Payers and Providers (Non-Members)

Robin Fisk, Editor in Chief and co-author of Chapter 17, Considerations in the Absence of a Contract Between Provider and Payer, is a health lawyer focusing on managed care and business transactions. She has represented providers, practitioners, and managed care organizations. Robin has functioned as in-house counsel for managed care companies in metro New York, Texas, and Massachusetts, served as lead counsel for four insurer start-ups, several service line and service area expansions, and as contract counsel to national providers. Pursuing a longstanding interest in improving the way services are delivered, she recently completed her Master’s of Health Care Delivery Science, a program jointly sponsored by the Tuck School and the Dartmouth Institute. Robin has also taught health law at the Master’s level. She graduated from Boston University School of Law and the University of Pittsburgh a very long time ago.

Christina DeGraff-Murphy, Editor, is the Assistant General Counsel of Contracting for The University of Vermont Health Network consisting of six Affiliate hospitals in New York and Vermont, including an academic medical center, several skilled nursing facilities and other health care entities. She represents the organization on a wide range of matters with an emphasis on managed care, ASO and ACO contracting. Christina balances strategic and business initiatives with contractual and legal requirements in managed care negotiations, contracting, and dispute resolution, alternative payment methodology arrangements, and general contracting to support network initiatives. This is Christina’s first time serving as an Editor for the AHLA’s Health Plans Contracting Handbook. Christina is an alum of Western New England School of Law (2001) and Western New England University (1998). Christina resides in Vermont with her husband and three children.

Gregory R. Mitchell, Editor, is an associate in the law firm of Epstein Becker & Green PC and is based in the firm’s New York office. He focuses his practice on advising health systems, medical groups, independent practice associations, accountable care organizations, and other providers, provider groups, and intermediary entities on a range of managed care-related matters. He negotiates and drafts managed care agreements by and among managed care companies, insurers, hospitals, health systems, independent practice associations (IPAs) and similar provider organizations, behavioral health and substance use disorder treatment providers, physicians, and ancillary providers relating to Medicare Advantage, Medicaid managed care, as well as fully-insured and self-insured lines of business. He negotiates and drafts agreements relating to innovative payment models; including full risk/capitation, bundled payment, and shared savings/losses models; prepares agreements relating to the delegation of management functions by managed care entities to third parties; and negotiates and prepares managed care agreements between health care providers and managed care entities and insurers for reimbursement in traditional reimbursement models. In addition, he has spoken and coauthored articles on various health care topics including social determinants of health, encounter data, and the Affordable Care Act’s impact on health insurance and provider.

Gregory is an alumnus of Emory University School of Law and Union College.