Managed Care Litigation: Anti-Assignment Clauses, Reimbursement Claims, State Law Claims
A live 90-minute CLE video webinar with interactive Q&A
This CLE webinar will guide healthcare counsel on the recent developments in managed care litigation. The panel will address anti-assignment clauses, claims related to reimbursement, and more. The panel will discuss strategic and practical considerations involved in litigating managed care matters.
Outline
- State law OON reimbursement claims
- Anti-assignment clauses
- ERISA preemption
- No Surprises Act
- Recoupments and offsets
- Hot topics/new developments
Benefits
The panel will review these and other important issues:
- What are the bases for the current 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 risk of managed care suits?
Faculty
Michael H. Bernstein
Partner
Robinson & Cole
Mr. Bernstein manages litigation from inception through trial, arbitration, and appeal and has successfully defended... | Read More
Mr. Bernstein manages litigation from inception through trial, arbitration, and appeal and has successfully defended life, health, and disability claims brought in state or federal court against insurers, plan administrators, employers, and managed care organizations. He regularly represents HMOs; PPOs; third-party administrators; pharmacy benefit managers; and life, health, disability, and accidental death and dismemberment benefit plans. In addition, Mr. Bernstein represents insurance companies, managed behavioral health care claim administrators, chiropractic health care claim administrators, self-funded plan sponsors, and administrators in a variety of matters. His experience spans all areas of life, health, and disability litigation, including complex health care issues involving ERISA, FEHBA and Medicare preemption, payor/provider contract disputes, provider de-listing disputes, PBM antitrust claims, nonparticipating provider reimbursement claims, pharmacy benefit plan/provider disputes, and behavioral health claim disputes, including claims alleging violations of federal and state Mental Health Parity and Addiction Equity laws. Mr. Bernstein has written extensively about managed care litigation, health care issues, group benefits, and ERISA matters, and has presented on these topics at conferences and seminars around the country.
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Eliot T. (Eli) Burriss
Partner
Faegre Drinker Biddle & Reath
Mr. Burriss represents clients in sophisticated litigation matters, with a scope that includes derivative actions,... | Read More
Mr. Burriss represents clients in sophisticated litigation matters, with a scope that includes derivative actions, M&A disputes, software license and data breach litigation, antitrust litigation, and trade secret litigation. He also has extensive experience litigating matters that arise under the Employee Retirement Income Security Act (ERISA), including 401(k) litigation, employee stock ownership plan (ESOP) litigation, and representing some of the world’s largest health plan administrators and insurers, advising on a variety of litigation matters, including anti-fraud litigation, provider disputes and regulatory issues.
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Brian R. Stimson
Partner
Arnall Golden Gregory
Providers frequently retain Mr. Stimson to defend them in federal and state administrative audits, investigations, and... | Read More
Providers frequently retain Mr. Stimson to defend them in federal and state administrative audits, investigations, and enforcement actions. He is uniquely equipped to defend providers in such matters as a former high-level HHS official. He has successfully guided an array of providers through revocations, payment suspensions, overpayment recoupments, Medicare debt collections, surprise billing investigations, civil rights investigations, Provider Relief Fund audits, and False Claims Act actions. Providers also look to Mr. Stimson as a trusted advisor on the regulatory issues adjacent to his litigation practice. Those issues include managed care contracting, the federal and state surprise billing laws, Medicare fee-for-service reimbursement, the Medicare Advantage program, HIPAA, and the federal rulemaking process generally. The insights that Mr. Stimson brings from his years at HHS as Acting General Counsel and Principal Deputy General Counsel are what sets him apart from other lawyers. At HHS, he was the lead in-house lawyer for administrative litigation. He personally drafted and cleared agency rules as part of the inter-agency process and was a liaison to both the Office of Counsel to the Inspector General and the U.S. Department of Justice.
CloseEarly Discount (through 02/07/25)