Disputes and Litigation in the Managed Care Industry: Mitigating Risk and Practical Guide
Overview:In this two-hour LIVE webcast, a panel of distinguished professionals and thought leaders will help executives and attorneys of managed care organizations (MCOs) understand the important aspects of this significant topic. They will provide an in-depth discussion of disputes and litigation in the managed care industry. Speakers will also offer best practices for risk mitigation and practical guidance on how to effectively navigate through the thorny process of managed disputes and litigation.
Some of the major topics that will be covered in this course are:
- Managed Care Disputes and Litigation: A Brief Overview
- Consumer Fraud Claims
- Litigation Cases under the Affordable Care Act
- Effective Strategies to Mitigate Risks for Disputes and Litigation
Litigation Trends Under the ACA including litigation over:
- The creation and implementation of “narrow networks.”
- The benefits required to be provided as “essential health benefits.”
- Rebates owed as a result of medical loss ratio calculations.
- Liability for services provided during the 90-day grace period.
- Continued and Emerging Trends in UCR/Provider Charge Disputes
- Leveraging data analysis to manage the cost of litigation
- Risk mitigation considerations from ACOs and the Affordable Care Act
- Mitigating and Evaluating Risk in Government payment and reporting
Looney Cohen & Aisenberg LLP
- ERISA Issues in Managed Care Disputes;
- Managed Care in Medicaid;
- Arbitration and Alternative Dispute Resolution
- Efficiently Litigating Disputes.
Molly Moriarty Lane is a partner in Morgan Lewis’s Litigation Practice and Managing Partner of the San Francisco office. Ms. Lane focuses her practice on complex litigation in California state and federal courts across a range of industries, including the healthcare, retail, technology, and financial services sectors. Ms. Lane represents clients through the entire litigation life cycle, from pre-litigation counseling to trials and appeals.
In the healthcare sector, Ms. Lane represents health plans, health insurers, prescription benefit management companies, and related entities in a wide variety of matters, including consumer and unfair competition class actions, claims for bad faith denial of benefits, policy rescission actions, pharmaceutical litigation, and general commercial disputes. In the retail and technology sectors, Ms. Lane has a strong background in class and individual claims for breach of contract, business torts, unfair competition, trade secret theft, antitrust, defamation, and copyright violations.
Ms. Lane is admitted to practice in California and before the U.S. District Courts for Northern, Eastern, Central, and Southern Districts of California and the U.S. Court of Appeals for the Ninth Circuit.
Molly Moriarty Lane is a partner in Morgan Lewis’s Litigation Practice and Managing Partner of the San Francisco office. Ms. …
Mary Beth Edwards is a Managing Director in the Washington, DC office of Navigant and is the national leader for Navigant’s Payer, Provider and Pharmacy sector of the Dispute, Compliance and Investigations practice. Ms. Edwards provides consulting and expert testimony services relating to the payment and adjudication of healthcare services and benefits, often in the context of contractual or regulatory disputes or investigations. Her experience includes working with payers (commercial and government-sponsored programs), providers (acute care providers, ancillary providers, pharmacies) and manufacturers.
Mary Beth Edwards is a Managing Director in the Washington, DC office of Navigant and is the national leader for …
Steve Kasten is a Partner in the law firm of Looney Cohen & Aisenberg, LLP, located in Boston, Massachusetts. He has more than 20 years of experience trying, arbitrating and assisting clients in resolving significant business disputes, professional liability claims, and class actions. Steve regularly represents health care providers, provider organizations and managed care plans in a variety of business disputes, whether between providers and plans, among constituents within health care organizations, or in defense of class actions. He has significant experience with ERISA issues and claims, both in relation to health plans and retirement plans. Steve has received the highest Martindale Hubbell peer rating of AV-Preeminent™ and appears regularly as a Massachusetts Super Lawyer® for business litigation. He serves on the American Arbitration Association’s roster of arbitrators for commercial disputes.
Steve Kasten is a Partner in the law firm of Looney Cohen & Aisenberg, LLP, located in Boston, Massachusetts. He …
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Method Of Presentation:
NASBA Field of Study:
Specialized Knowledge and Applications
NY Category of CLE Credit:
Law Practice Management
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About Morgan Lewis
Founded in 1873, Morgan Lewis offers more than 1,600 legal professionals – including lawyers, patent agents, benefits advisers, regulatory scientists, and other specialists – in 25 offices across the United States, Europe, Asia, and the Middle East. The firm provides comprehensive litigation, corporate, transactional, regulatory, intellectual property, and labor and employment legal services to clients of all sizes – from globally established industry leaders to just-conceived start-ups. For more information about Morgan Lewis or its practices, please visit us online at www.morganlewis.com.
About Looney Cohen & Aisenberg LLP
Looney Cohen & Aisenberg, LLP is a boutique law firm located in Boston, Massachusetts focusing on business litigation and commercial lending and real estate transactions. Each of our partners has had extensive experience and success in large regional or national law firms and has practiced law for more than twenty years. Our firm represents banks, developers, private and public companies and their constituents, health care organizations and other non-profits in a range of transactions and disputes. We employ our experience collaboratively, where necessary in combination with outside resources, to deliver the highest-quality legal services to clients on matters from the simple to the complex, in cases large and small, with personal attention and deep involvement of our senior lawyers. We strive to do so economically by charging rates that are fair, working efficiently and, most importantly, through early case assessment and strategic planning with our clients.