What Is ADR In Healthcare? What Is The Process Of ADR?

ADR or alternative dispute resolution is available in healthcare disputes under certain circumstances. However, if a healthcare provider has a dispute with a governmental entity (Medicare or Medicaid), there are no alternative dispute resolution available. It is a process of having an informal hearing to determine what the issues are and allowing the healthcare provider to set out mitigating circumstances and a way in which to resolve the issue within the guidelines of that governmental entity. If no resolution can be had, then the governmental entity would put the provider on notice and there would be a formal administrative hearing with evidence heard by a hearing officer, much like a judge. Then, a recommendation would be made to the Director which would be final and subject to appeal by either the governmental entity or the healthcare provider.

Healthcare entities who do business with one another where state governmental entities are not a party can provide mandatory arbitration, optional arbitration, non-binding mediation, or binding mediation. If reasonable, it would be enforced as written in the contract.

What Are The Three Main Alternative Dispute Resolution Methods In Healthcare?

Binding arbitration, non-binding mediation, and binding mediation are the three main dispute resolution methods in healthcare. In the old days, the way to mediate a matter would be to have one party’s attorney sit down with the other party’s attorney and work the issues out. Now, mediation and arbitration have become much more popular.

What Are The Pros And Cons Of ADR In Healthcare Litigation?

Many times, when you’re dealing with healthcare providers or manufacturers, time is of the essence because of the service they provide and the constant ongoing need for people to receive healthcare. Many times, healthcare providers believe that the alternative dispute resolution process makes for a timelier disposition. However, many times, you will find the parties feel like unless they have had their day in court, they really haven’t resolved an issue. If you are in court and you have a legal decision handed down by a judge, then that is generally stronger and parties are much less likely to try to circumvent that ruling in the future.

Is One Method Of ADR More Preferable When It Comes To Resolving Healthcare Disputes?

In my opinion, lawyer-to-lawyer negotiation has the advantage of quickly resolving the issue, understanding the legal ramifications, and putting the parties back on the track of providing healthcare.

Why Is ADR Preferred In Healthcare Disputes Over Litigation?

In a healthcare dispute, litigation can be drawn out and lengthy. Providers’ obligations are split from the productivity of the healthcare they provide to litigation. It is also a very expensive proposition that may very well last years. This is why alternative dispute resolution is desirable and much more beneficial in a healthcare setting.

Are All Methods Of Alternative Dispute Resolution Involving Healthcare Issues Binding?

When private entities are dealing with other private entities, it would depend on what the contract set out. It could set out non-binding mediation, binding mediation, or binding arbitration. In many instances, you have binding arbitration agreements where one party would file suit on either the constitutionality of the binding arbitration or the onerous provision of the binding arbitration and ask a court to set aside the provision of binding arbitration to allow one of the parties to go to court. If both sides were represented by lawyers and they entered into an agreement that provided for binding arbitration, most of the time, Mississippi courts have held that the parties are bound by that mandatory arbitration provision.

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