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Managed Care Litigation: Anti-Assignment Clauses, Reimbursement Claims, State Law Claims

Recording of a 90-minute CLE video webinar with Q&A

This program is included with the Strafford CLE Pass. Click for more information.
This program is included with the Strafford All-Access Pass. Click for more information.

Conducted on Thursday, February 16, 2023

Recorded event now available

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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.

Description

To minimize the risk of litigation from healthcare providers many health plan sponsors include anti-assignment provisions in the insurance contracts. These provisions prohibit or substantially limit plan participants from being able to assign their rights under the plan. The Ninth Circuit Court of Appeals held that plans waive these provisions when they act inconsistently with them. Beverly Oaks Physicians Surgical Ctr., LLC v. Blue Cross & Blue Shield of Ill. (9th Cir. 2020). The Third Circuit Court of Appeals noted that providers can bypass anti-assignment clauses if they hold valid powers of attorney. American Orthopedic & Sports Med. v. Ind. Blue Cross Blue Shield (3d Cir. 2018). These developments have shifted how litigators approach anti-assignment issues.

Managed care disputes also address a variety of other issues, including state law reimbursement claims by out-of-network providers; ERISA preemption; recoupments and offsets; the No Surprises Act; and other hot topics.

Listen as our authoritative panel of healthcare attorneys examines recent developments in managed care litigation. The panel will discuss anti-assignment clauses; claims related to reimbursement; full and fair review of ERISA claims; and state law claims. The panel will discuss strategic and practical considerations involved in litigating managed care matters.

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Outline

  1. State law OON reimbursement claims [David/Alison]
  2. Anti-assignment clauses [Joel]
  3. ERISA preemption [Joel]
  4. No Surprises Act [Alison]
  5. Recoupments and offsets [David]
  6. 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

Andersen, Alison
Alison Lima Andersen

Partner
ArentFox Schiff

Ms. Anderson’s work is primarily in the areas of ERISA and other employee benefits litigation, healthcare...  |  Read More

Greenberg, David
David S. Greenberg

Partner
ArentFox Schiff

Mr. Greenberg advises health care companies, including providers and suppliers, through an exceedingly...  |  Read More

Mintzer, Joel
Joel A. Mintzer

Of Counsel
Herman Law Firm

Mr. Mintzer brings a breadth of litigation experience, arising from 22 years at a national law firm, and the insight of...  |  Read More

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