📝 5 Dangerous Clauses to Watch for in Your Payor Contract

Your payor contract isn't just paperwork—it controls how you're paid, when you're audited, and how much power the insurer has over your practice.

Unfortunately, most small healthcare organizations never read their contracts closely, and by the time a problem arises, it’s too late to renegotiate.

In this guide, we break down five common contract clauses that can quietly damage your revenue and leverage—and how to protect yourself.

1. ⚖️ Unilateral Amendment Clause

A unilateral amendment clause allows the payor to change the terms of your agreement without your approval.

That means they could:

  • Lower your reimbursement rates

  • Change documentation requirements

  • Enforce new billing policies—with no warning

What to Do:

  • Push for written notice requirements (at least 30 days)

  • Request the right to terminate the contract if key terms are changed

Without notice protections, you’re agreeing to a moving target.

2. 💸 Most Favored Nation (MFN) Clause

This clause requires you to offer the payor your lowest rate—even if another payer is part of a short-term discount or government program.

Why It’s Risky:

  • Locks you into your worst rate

  • Prevents pricing flexibility with new payors

  • Can hurt negotiations with Medicare Advantage or Medicaid MCOs

What to Do:

  • Negotiate to remove MFN clauses entirely

  • If that’s not possible, limit their scope (e.g., exclude government payors or cap the duration)

3. 🧾 Retroactive Recoupment Provisions

Some payor contracts allow recoupment years after they’ve paid your claim—usually after an audit or retroactive policy change.

Risks:

  • Surprise withholds or clawbacks

  • Financial exposure without clear timelines

  • Delayed recoupments triggered by vague audit terms

What to Do:

  • Limit recoupment timeframes (e.g., 12 months after payment)

  • Add language requiring joint resolution before withholds

4. 🛠️ Vague Dispute Resolution Language

Dispute resolution clauses that are unclear—or favor the payor—can leave you stuck in unfair arbitration or limit your legal options.

What to Look For:

  • Mandatory arbitration in the payor’s home state

  • No clear appeal process

  • Prohibition against using state provider complaint portals

What to Do:

  • Ask for neutral venues in dispute clauses

  • Confirm whether you're allowed to file formal complaints with your state’s Department of Insurance or Medicaid agency

5. 🧪 Overly Broad Audit Clauses

Audit language like "we may audit any records at any time for any reason" is far too broad and opens the door for fishing expeditions.

Why It’s a Problem:

  • Can trigger endless record requests

  • Increases risk of unjustified recoupments

  • Lacks safeguards for provider input or dispute

What to Do:

  • Define a specific audit scope and reasonable time limits

  • Require advance notice and the opportunity to respond before repayment is enforced

🧠 Final Thoughts

Payor contracts are binding legal agreements that directly impact your revenue, audit exposure, and long-term business stability. Even a 60-minute legal review could reveal clauses that are quietly costing your practice thousands—or exposing you to risk.

Need help reviewing or renegotiating a provider agreement? Let’s protect your practice before problems arise.

Hurley Law Group
Healthcare Law for Small & Midsized Providers
📞 308-383-1867
🌐 hurleylawgroup.com
✉️ eric@hurleylawgroup.com

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✍ Responding to Payor Recoupment Demands After an Audit: A Legal Guide for Small Practices

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⚖️ 7 Common Legal & Compliance Issues for Small Healthcare Organizations