Managed Care Disputes: Litigating Issues Involving Coverage, Payment Practices and More
Recording of a 90-minute CLE webinar with Q&A
This CLE course will prepare healthcare counsel to litigate managed care claims. The panel will discuss legal, substantive and practical considerations in common areas of dispute.
Outline
- Hot topics in coverage litigation
- ACA-related litigation
- Medical loss ratio requirements
- Provider inclusion and exclusion from networks
- Coverage disputes over emergent care and mental health benefits
- Out-of-network reimbursement trends and litigation
- ERISA litigation trends
- Antitrust actions targeting insurer plans’ geographic distribution of markets
- Payer actions challenging provider waivers of co-insurance, co-pays and deductibles
Benefits
The panel will review these and other critical questions:
- What are the bases for the recent wave of managed care suits—and what defenses are available to providers and healthcare plans?
- What are proven litigation and settlement strategies for counsel litigating managed care claims?
- What are best practices for counsel to providers and healthcare plans to minimize the expanding risk of managed care suits?
Faculty
Edwin E. Brooks
Partner
McGuireWoods
As national counsel for one of the largest government-sponsored health plans, Mr. Brooks handles healthcare litigation... | Read More
As national counsel for one of the largest government-sponsored health plans, Mr. Brooks handles healthcare litigation around the country. He also represents healthcare providers, including hospitals, health systems, and nursing homes. Mr. Brooks is an adjunct professor at Northwestern University Law School where, for 16, he has taught trial advocacy classes. He was a board member for two Illinois managed care organizations. Mr. Brooks was Vice-Chair of the Health Care Liability & Litigation Group of the American Health Lawyers Association for six years.
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Jonathan M. Herman
Managing Member
Herman Law Firm
Mr. Herman is a seasoned lawyer who has spent most of his legal career representing large health insurers, plan... | Read More
Mr. Herman is a seasoned lawyer who has spent most of his legal career representing large health insurers, plan administrators, and self funded health plans in managed care disputes, often arising under the provisions of ERISA. His Managed Care Litigation Update, is widely read by in-house health plan counsel across the country, enabling them to better serve internal clients by tracking litigation trends and forecasting potential disputes.
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