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 with Q&A

Conducted on Thursday, March 11, 2010

Recorded event now available

or call 1-800-926-7926
Course Materials

This CLE course 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.


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.



  1. Managed care litigation — historical perspective
  2. Common allegations and current litigation trends
    1. Balance billing
    2. Reimbursement
    3. Physician tiering
    4. Treatment coverage
    5. Silent PPOs
    6. Post-claims rescission of insurance policy
    7. ERISA preemption
    8. Provider inclusion and exclusion from networks
  3. Affirmative cost recovery litigation against third parties
  4. On the horizon — regulatory and legislative trends


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?


Christopher Flynn
Christopher Flynn

Crowell & Moring

He represents HMOs, PPOs, IPAs, health benefit plans and managed behavioral healthcare organizations. His experience...  |  Read More

James W Boswell, III
James W Boswell, III

King & Spalding

He has extensive experience in handling a full range of commercial litigation matters. He has handled jury trials,...  |  Read More

Robert T. Rhoad
Robert T. Rhoad

Crowell & Moring

He is Co-Leader of the firm's Health Care Litigation Team and his primary area of specialization relative to the health...  |  Read More

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