Managed Care Litigation: Emerging Trends in Provider-Plan Disputes
Pursuing and Defending Lawsuits Involving Balance Billing, Reimbursement, Physician Tiering and Other Claims
Recording of a 90-minute CLE webinar/teleconference with Q&A
Conducted on Thursday, March 11, 2010
Recorded event now available
This CLE webinar will prepare healthcare litigators pursuing and defending managed care litigation to understand and leverage the emerging substantive, strategic and practical considerations in key areas of dispute such as billing and reimbursement issues, treatment coverage, and physician tiering, among others.
Description
Financial pressures in the healthcare industry have spurred an increase in managed care litigation. Recent litigation has centered on balance billing, reimbursement rates, treatment coverage, physician tiering, post-claims rescission of policies, and the enforceability of arbitration clauses.
Managed care litigation involves complicated issues of ERISA preemption, vicarious liability theories, and the potential for corporate negligence, and often results in excessive jury verdicts. Pursuing and defending managed care lawsuits requires meticulous litigation planning.
Listen as our authoritative panel of healthcare litigators analyzes recent developments in managed care litigation and discusses substantive, strategic and practical considerations involved in pursuing and defending lawsuits.
Outline
- Managed care litigation — historical perspective
- Common allegations and current litigation trends
- Balance billing
- Reimbursement
- Physician tiering
- Treatment coverage
- Silent PPOs
- Post-claims rescission of insurance policy
- ERISA preemption
- Provider inclusion and exclusion from networks
- Affirmative cost recovery litigation against third parties
- On the horizon — regulatory and legislative trends
Benefits
The panel will review these and other key questions:
- What are the bases for the recent wave of managed care lawsuits—and what defenses are available to providers and healthcare plans?
- What litigation and settlement strategies have proven effective for counsel pursuing and defending managed care claims?
- What best practices can counsel for providers and healthcare plans employ to minimize the expanding risk of managed care litigation?
Faculty
Christopher Flynn,
Partner
Crowell & Moring, Washington, D.C.
He represents HMOs, PPOs, IPAs, health benefit plans and managed behavioral healthcare organizations. His experience includes all areas of managed care law, including payor/provider reimbursement disputes, class action defense, ERISA preemption, subrogation disputes, regulatory challenges, whistleblower claims, and challenges to emerging medical procedures and devices.
James W Boswell, III,
Partner
King & Spalding, Atlanta
He has extensive experience in handling a full range of commercial litigation matters. He has handled jury trials, administrative hearings, arbitrations and appellate arguments involving specialized healthcare issues on behalf of healthcare industry clients. He is Chair of the Healthcare Liability and Litigation Practice Group of the American Health Lawyers Association.
Robert T. Rhoad,
Partner
Crowell & Moring, Washington, D.C.
He is Co-Leader of the firm's Health Care Litigation Team and his primary area of specialization relative to the health care industry is complex litigation involving the federal False Claims Act, state false claims laws, fraud and abuse matters, antitrust claims, and criminal and civil government enforcement actions.
Ordering
Online CLE - Audio Recording
Includes audio streaming of full program plus handouts (available 24 hours after live seminar).
CLE:
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Online CLE Audio $149.00
Available 24 hours after the live event
Recorded Event
Includes full event recording plus handouts (available after live seminar).
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Available ten business days after the live event
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Customer Reviews
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Northwestern Memorial Hopsital
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Texas Tech University Health Sciences Center
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Hogan & Hartson
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Bullivant Houser Bailey
Health Law Advisory Board
Partner
Arent Fox
Partner
Faegre Baker Daniels
Partner
Rivkin Radler
Principal
Ober Kaler
Partner
Garfunkel Wild & Travis
Partner
McDermott Will & Emery
Donald H. Romano
Of Counsel
Foley & Lardner
Partner
Foley & Lardner
Partner
Drinker Biddle & Reath
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