Practices

Litigation

Health Care Litigation

We have represented insurers, hospitals, vendors, practice groups, and individuals regarding a wide variety of health care issues, including those relating to reimbursement and those flowing from sales and acquisitions of assets, vendor agreements, and employment decisions. We have represented managed care and health maintenance organizations in cases brought by health care providers alleging improper claims processing or payment procedures. We have also guided health care providers through the legal issues created by changes in the health care system, such as managed care and vertical and horizontal consolidation. Our health care litigators have also represented health care clients in parallel criminal and civil proceedings. 

We have provided a wide range of advice to health care clients on issues concerning home health care, fraud and abuse, reimbursement, hospital privileges, antitrust, affiliation agreements and other contractual arrangements between health care facilities and between health care owners and managers.  

We successfully defended the Pennsylvania Department of Health, the Secretary of Health, and the Deputy Secretary of Quality Assurance in an action filed in the Pennsylvania Commonwealth Court by four hospitals in western Pennsylvania that sought to perform angioplasty services despite a lack of on-site heart surgical backup centers. The Court rejected the hospitals’ reliance on specific language in the 2005 General Appropriation Act as an unconstitutional nullity.  

We represented the Pennsylvania Insurance Department in its examination of the filing by Pennsylvania’s two largest health insurers, Highmark and Independence Blue Cross, proposing to consolidate into a new company. Though the proposed merger was eventually called off, we worked with expert economists and financial consultants to provide legal analysis of the antitrust aspects of the governing law, as well as analysis of health care policy and regulatory process issues.   

In another matter, less than one week before trial, we were engaged by an existing firm client to be co-counsel in defending it against a $1.5 million malpractice claim.  We learned the case in a matter of days and tried it with the client’s other counsel. After an eight-day trial in the Philadelphia Court of Common Pleas, the jury returned a defense verdict, exonerating our client. Plaintiffs then filed an appeal with the Pennsylvania Superior Court, which affirmed the defense verdict. 

We frequently represent affiliates of a leading, multibillion-dollar global property and casualty insurance firm. The representation has included the following matters:  

  • Managed care coverage and bad faith litigation throughout the country, including successful resolution of actions against Blue Cross and Blue Shield franchisees in Florida, Pennsylvania, and Illinois arising out of underlying managed care litigation brought by physicians and patients;
  • Coverage matters relating to hospitals in several cities in which the insured were being sued for antitrust conspiracies to depress nursing wages; 
  • Representation against a major health care services provider in federal courts in New York and Minnesota arising out of claims by patients and physicians alleging state and federal causes of action for under-reimbursement for out-of-network claims.

Litigation Attorney Listing