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
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.
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
He represents HMOs, PPOs, IPAs, health benefit plans and managed behavioral healthcare organizations. His experience... | Read More
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.
CloseJames W Boswell, III
Partner
King & Spalding
He has extensive experience in handling a full range of commercial litigation matters. He has handled jury trials,... | Read More
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.
CloseRobert T. Rhoad
Partner
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
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.
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