Firms To Watch: Health insurers

Holland & Knight LLP continues to strengthen its healthcare insurance practice, adding several new clients to its roster in 2022. Practice co-head Jeffrey Mittleman, based in Boston, specializes in fraud and abuse cases with a focus on anti-kickback statutes, while transactional expert Jennifer Rangel advises clients from her base in Austin.
Counting market-leading national healthcare plan providers among its clients, Robins Kaplan LLP has a strong and growing litigation offering in the healthcare insurance space. Led by Jeffrey Gleason, Jamie Kurtz, and Thomas Mahlum, 2022 saw the firm secure several victories for its clients in high-stakes insurance-related defensive litigation.

Health insurers in United States

Epstein Becker & Green, P.C.

Highly acclaimed for its ‘exceptional depth of knowledge and experience‘ across the spectrum of the healthcare and life sciences industries, Epstein Becker & Green, P.C. acts for healthcare providers, health plans, and insurers on contentious and non-contentious matters. A one-stop shop for healthcare law, the firm’s deep bench of lawyers has experience from within the healthcare industry as well as from regulatory and governmental bodies. Litigation is a core area of strength for the firm, with a strong record representing clients in federal and internal investigations and fraud and abuse litigation. Its transactional and regulatory practice is equally strong, advising large national health insurance providers and service providers on issues of reimbursement, investment opportunities and risks, and compliance. George Breen and Mark Lutes co-head the team from its Washington DC office. Also in DC are Gregory Epstein, regulatory specialist Kevin Malone, and False Claims Act expert Jason Christ, while the ‘fantasticJohn Gilbertson advises clients from his base in Los Angeles. Other key members of the team include Lynn Shapiro Snyder and founding partner Steven Epstein, both based in DC, as well as New York-based Jackie Selby.


Practice head(s):

Mark Lutes; George Breen


Other key lawyers:

Steven Epstein; John Gilbertson; Jackie Selby; Gregory Epstein; Kevin Malone; Jason Christ; Lynn Shapiro Snyder


Testimonials

‘Outstanding team of professionals. Exceptional depth of knowledge and experience in the healthcare industry.’

‘Excellent spirit of advocacy and service orientation. John “Jack” Gilbertson is fantastic.’

Manatt, Phelps & Phillips, LLP

Manatt, Phelps & Phillips, LLP‘s market-leading health insurance practice has a strong full-service practice with deep expertise across the sector. The team’s multidisciplinary expertise runs the gamut of health insurance-related issues, advising leading national insurers on both contentious and non-contentious issues. Core focus areas include high-profile litigation, transactional work, and regulatory issues, as well as Medicare managed care compliance. The team is led by the New York-based William Bernstein, whose practice concentrates on advising financial institutions, managed care companies, and health insurers on transactional and corporate matters. Also in New York are transactional and regulatory experts Robert Belfort and Randi Siegel. On the litigation side, Los Angeles-based Ileana Hernandez and Gregory Pimstone represent major health plans and insurers in consumer and unfair competition actions and in federal and state investigations. Other key members of the team include LA’s Paul Carr-Rollitt, who handles major transactions, and Medicaid and ACA experts Anne Karl and Michael Kolber, both based in New York.

Practice head(s):

William Bernstein


Other key lawyers:

Robert Belford; Ileana Hernandez; Randi Siegel; Gregory Pimstone; Anne Karl; Michael Kolber; Paul Carr-Rollitt; Megan Thibaut-Ind; Stephen Libowsky


Key clients

Benefis


Ann & Robert H. Lurie Children’s Hospital of Chicago


City of New York/New York City Health + Hospitals Corporation


Humana


New York State Coalition of Anchor Safety Net Hospitals


North Carolina Department of Health and Human Services


Yale New Haven Health


Northwell Health


Dignity Health


Health Net


Canopy Health


Blue Shield of California


Memorial Sloan Kettering Cancer Center


California Department of Health Care Services


Work highlights


  • Advised Humana in a multistage transaction that involved Humana’s buyout of TPG Capital and Welsh Carson as owners of Kindred at Home (KAH); the spin-off of KAH’s hospice business from its health home business; and a sale of the hospice business to a private equity firm.
  • Advising the state of North Carolina (NC) in transforming its Medicaid delivery system, including transitioning from fee-for-service to Medicaid managed care.
  • Represented Dignity Health in a suit brought by the American Civil Liberties Union (ACLU) on behalf of Physicians for Reproductive Health and an individual, after the hospital followed binding ethical and religious directives for Catholic health care in denying the individual’s request for an elective sterilization procedure.

McDermott Will & Emery LLP

With its full-service healthcare offering across contentious and non-contentious matters, McDermott Will & Emery LLP is a go-to choice for clients across the healthcare insurance sector, including major healthcare providers, private equity funds, and hospital groups, who seek the firm out for its ‘top-notch‘ healthcare insurers team. In Washington DC, Jeremy Earl advises health insurers on federal and state regulatory matters, as well as ACA market reform compliance, while Kate McDonald focuses her practice on state and federal regulatory and licensure compliance. On the contentious side, former federal healthcare fraud prosecutor Ankur Goel specializes in representing health industry clients in False Claims Act and Medicare Advantage litigation matters. Jerry Sokol, based in Miami, leads the overall practice. Also in Miami is transactional specialist Gary Scott Davis, concentrating on managed care mergers, joint ventures, and contractual matters. Other key names include Chicago’s Lisa Mazur and Eric Zimmerman, both in DC. Jason Caron and Kevin Miller left the firm in 2022, while Brian Stimson departed in September 2023.

Practice head(s):

Jerry Sokol 


Testimonials

The healthcare team at MWE is top-notch. Their attorneys are practical, concise, and take the time to understand business strategy and imperatives as they deliver their advice.’

Caroline Reignley and Lisa Mazur are my go-to healthcare regulatory attorneys for sound legal advice given their deep expertise, understanding of the business context, and experience counseling clients on cutting-edge issues in digital health.’

McDermott Will & Emery has a great healthcare practice that provides very practical, high quality legal advice at a cost-effective price. The attorneys I have worked with are incredibly responsive, willing to join calls after hours or on weekends if needed. They provide creative solutions.

Anisa Mohanty is a highly skilled healthcare attorney who provides excellent legal advice. She produces a high quality written product very quickly.’

Key clients

CVS Health


Future Health


H.I.G


Nautic Partners


Enhanced Healthcare Partners


Prime Therapeutics


Novant Health


Cigna


St. Luke’s Health System


Devoted Health Plan


Work highlights


  • Represented CVS Health as healthcare regulatory counsel in its definitive agreement to acquire publicly-traded Signify Health, Inc.
  • Representing Future Health in its USD459 million agreement with Excelera Health.
  • Advised Prime Therapeutics LLC in its USD1.35 billion acquisition of Magellan RX Management, a pharmacy company, from Centene Corp.

Dentons

Dentons has a full-service health insurance offering, advising clients on all matters transactional, regulatory, and contentious. Known in particular for its representation of managed care organizations, the team regularly advises on Medicare Advantage and Part D matters. Co-head Bruce Merlin Fried of Washington DC combines previous legal and policy healthcare experience from the public and private sectors, having served as the director of the Center for Health Plans and Providers at the Center for Medicare and Medicaid Services. New York-based co-head Janice Ziegler provides insurers and providers with regulatory and litigation enforcement issues with particular expertise on Medicare Secondary Payer laws. Also in New York, Claire Bornstein advises on federal and state regulatory healthcare insurance issues. Bornstein was promoted to partner in March 2022, further strengthening the firm’s regulatory offering, while Honolulu-based commercial litigator Dianne Winter Brookins heads the firm’s Hawai’i practice. Seasoned insurance litigator Michael Barnes, based in San Francisco, is another key name in the practice. Helen Reeves left the firm in 2022.

Practice head(s):

Bruce Merlin Fried; Janice Ziegler


Other key lawyers:

Michael Barnes; Dianne Winter Brookins; Claire Bornstein;


Work highlights


  • Advised EssilorLuxottica on a streamlined research protocol for review and analysis of Medicaid state managed care model contracts.
  • Representing Shamir in a qui tam False Claims Act litigation filed in the US District Court for the Central District of California.
  • Providing UCare with federal government relations and healthcare regulatory counsel.

Greenberg Traurig LLP

Jointly headed by Nancy E. Taylor and David Peck, Greenberg Traurig LLP‘s health insurance team acts for national and regional insurers with a strong offering on regulatory and transactional matters. Taylor is based in Washington DC, where she specializes in FDA regulatory matters, ACA provisions, and CMS reimbursement and policy issues. Fort Lauderdale-based Peck assists private equity firms, investors, and other corporates with financing, acquisitions, and other transactional matters in the healthcare insurance space. Albany’s Eileen M. Hayes advises on Medicaid and managed care and insurance regulatory matters with a focus on the New York marketplace. Harold N. Iselin, also based in Albany, is praised for his ‘unparalleled‘ regulatory expertise, while Tricia A. Asaro is noted for her deep understanding of New York state regulatory matters. Other key names include Joseph F. Coniglio, practicing from Dallas, as well as of counsels Caroline Brancatella and Elizabeth Sacco, both in Albany.


Practice head(s):

Nancy E. Taylor; David Peck


Other key lawyers:

Tricia A. Asaro; Harold N. Iselin; Eileen M. Hayes; Joseph F. Coniglio; Elizabeth Sacco; Caroline Brancatella


Testimonials

‘The team has broad and very deep experience. Perhaps the strongest among peer organizations in the regulatory area for healthcare and the overall healthcare market. Helpful to have broad expertise under one roof.’

‘Harold Iselin – experience and knowledge of legal and regulatory matters, as well as his network, is unparalleled. Tricia Asaro’s experience with NY regulatory matters is very deep. All lawyers are a pleasure to work with. Their flexibility is wonderful.’

Key clients

Affinity Health Plan


MVP Health Care


MetroPlus Health Plan Inc.


Oscar Insurance Corporation


New York Health Plan Association


United HealthCare


Centene


Longevity Health Founders


Aetna


ProAssurance


Texas Association of Health Plans


Work highlights


  • Advised Affinity in the company’s recent sale to Molina Healthcare, Inc. and the distribution of the proceeds of the sale to community-based organizations through a grant program approved by the Attorney General of the State of New York.

Hogan Lovells US LLP

Hogan Lovells US LLP‘s health insurers practice stands out for its expertise in contentious matters, acting for major national insurers on a wide range of civil and criminal cases. The team is particularly proficient in ERISA matters, class action litigation, and coverage cases. Craig H. Smith, who advises on transactional and regulatory issues with a particular focus on internal investigations, is a key member of the firm’s Miami office. David Massey, also in Miami, advises Fortune 500 healthcare industry clients and managed care companies on class actions, healthcare fraud, and under-reimbursement litigation. Ronald Wisor leads the overall group from Washington DC, where litigator Sheree Kanner advises on Medicare and Medicaid matters in federal courts. New York’s Jeffrey Schneider focuses on compliance issues and transactions in the health insurance sector, while healthcare litigator Michael Maddigan represents insurers in commercial disputes, False Claims Act cases, and privacy matters from Los Angeles.

Practice head(s):

Ronald Wisor


Other key lawyers:

Craig H. Smith; Michael Maddigan; Sheree Kanner; Jeremy Schneider; David Massey


Testimonials

Hogan Lovells have tremendous experience with Florida health laws, regulations, and relationships with key stakeholders.

They are very knowledgeable and fierce advocates.

Key clients

UnitedHealthcare


Elevance Health (f/k/a Anthem)


Centene Corporation


Florida Association of Health Plans


Blue Cross and Blue Shield of Florida, Inc.


Health First


Molina Healthcare


Anthem Blue Cross of California


Medica


Work highlights


  • Represented UnitedHealthcare in various class action lawsuits across the country, including Florida and California, successfully resolving the matters in favor of the client.
  • Representing Molina Healthcare in a class action lawsuit filed by Comprehensive Pathology Associates alleging that Molina Healthcare’s Florida Medicaid health plan failed to comply with Florida law by not covering certain hospital-based pathology services.
  • Successfully resolved a major court lawsuit for Centene Corporation brought on behalf of an individual who alleged that Centene’s Florida Medicaid health plan was violating the U.S. Medicaid Act and the U.S Americans with Disabilities Act by denying coverage for certain healthcare services.

O'Melveny & Myers LLP

O'Melveny & Myers LLP‘s team receives praise for its ‘substantively outstanding‘ work in the healthcare insurance sector. Litigation is a particular area of strength for the practice, with the team successfully representing major healthcare insurers against alleged False Claims Act violations, class actions, and criminal investigations on state and federal levels. David Deaton, who heads the team from his base in California, represents major health insurers and companies in internal investigations, regulatory matters, and enforcement cases, with significant experience in the fields of anti-kickback and self-referral law as well as reimbursement issues and managed care regulation. Also in California are False Claims Act expert litigator Caitlin Blair, known for her work representing managed care organizations, and regulatory expert Stephen Sullivan, working from San Francisco and Los Angeles, respectively. On the East Coast, Washington DC-based Lee Blalack helms the healthcare litigation practice, representing clients before grand jury trials, congressional hearings, and regulatory investigations.

Practice head(s):

David Deaton


Other key lawyers:

Lee Blalack; Caitlin Bair; Stephen Sullivan


Testimonials

The O’Melveny & Myers team has deep and extensive experience in the healthcare false claims act space, which makes their team a step ahead of others. They also have a deep bench such that the quality of the service is not dependent on a couple of individuals. That team is also quite diverse and varied in experience levels. Their work product is well written, turned in ahead of time, and substantively outstanding. Most importantly, the team lays out a strategic goal for the case (and for within certain time periods) and then insures that every step is driving toward that goal.’

Lee Blalack leads the litigation strategy and David Deaton leads the strategic strategy. Between the two of them, they make sure that each step is made with the overall goals in mind. Caitlin Bair and Stephen Sullivan manage a very large case day-to-day and do so both strategically well as well with cost efficiencies in mind. All four are strategic thinkers who are client focused.

 

Key clients

BlueCross BlueShield of North Carolina


Cambia Health Solutions


Caresource


Clover Health


Elevance Health, Inc. (f/k/a Anthem, Inc.)


Excellus Health Plan, Inc.


Health Care Service Corporation


Humana Inc.


Kaiser Foundation Health Plan


Molina Healthcare


UnitedHealth Group and UnitedHealthcare Insurance Company


Work highlights


  • Representing UnitedHealth Group subsidiaries in seven lawsuits filed by out-of-network provider groups affiliated with TeamHealth.
  • Representing Elevance Health, Inc in FCA litigation related to Elevance Health’s Medicare Advantage risk adjustment practices.
  • Representing Kaiser Foundation Health Plan, Inc. and various Kaiser Permanente entities in FCA litigation that originated following the filing of six FCA qui tam actions.

Reed Smith LLP

The healthcare insurance team at Reed Smith LLP is noted for its strength on contentious matters, including fraud, waste and abuse issues, government investigations, and bad faith litigation. Drawing on the firm’s wider areas of expertise, the interdisciplinary team regularly acts on matters of national significance, including insurance-related antitrust, labor and employment law, and contract disputes. Washington DC-based Scot Hasselman co-heads the team, focusing on healthcare regulatory and policy matters with particular expertise in False Claims Act defense and anti-kickback compliance. Co-head Kurt Peterson, based in Century City, has a long track record of representing managed care organizations on a wide range of contentious issues. Chicago’s Marty Bishop is an experienced trial litigator whose practice focuses on a wide variety of contentious managed care issues. Rebecca Hanson, also in Chicago, and Kenneth Smersfelt, in Los Angeles, are other key members of the team.

Practice head(s):

Scot Hasselman; Kurt Peterson


Other key lawyers:

Marty Bishop; Kenneth Smersfeld; Rebecca Hanson


Sheppard, Mullin, Richter & Hampton LLP

Sheppard, Mullin, Richter & Hampton LLP’s healthcare practice has seen continuous growth over the last decade, and the firm has a solid healthcare offering with a particular focus on insurance-related transactional and regulatory issues. The team has an especially strong West Coast presence, with much of the team based in California. In Century City, Eric Klein leads the team, with a particular focus on healthcare insurance-related M&A and market consolidation, while Lynsey Mitchel’s practice concentrates on HMO regulatory matters. Eric Newsom represents buyers, sellers, and investors in private equity and venture capital investment transactions from his base in San Francisco, and Los Angeles-based Moe Keshavarzi is a trial and appellate lawyer with a focus on healthcare entities and insurers in civil disputes and regulatory enforcement actions. Washington DC’s Christine Clements rounds out the team, focusing on state and federal managed healthcare government contract programs.

Practice head(s):

Eric Klein


Other key lawyers:

Lynsey Mitchel; Eric Newsom; Moe Keshavarzi; Christine Clements


Testimonials

‘Extremely knowledgeable and hard-working practice. Intelligent attorneys at all levels from junior associates to partners. The group is very collaborative.’

‘Knowledgeable and hardworking.’

Key clients

Blue Shield of California (BSC)


SCAN Health Plan


Kaiser Foundation Health Plan, Inc


Honest Medical Group LLP


Centene Corporation


California Association of Health Plans


Physicians Medical Group of San Jose, Inc.


Hartford HealthCare


United Health and Kaiser Permanente


Altais, Inc.


agilon health, inc.


Hawai’i Medical Service Association


Renal Payer Solutions, Inc.


Delta Dental


Work highlights


  • Assisted Blue Shield California in the structuring and development of a joint venture with Walgreens, Inc. to create Blue Shield “Health Corners” inside California Walgreens locations.
  • Advised SCAN Health Plan in connection with its launch of SCAN Affirm, a first-of-its-kind Medicare Advantage plan for seniors in the LGBTQ+ community.
  • Represented Kaiser Foundation Health Plan, Inc. in connection with the San Diego Attorneys’ allegations that three health plans misled consumers by publishing inaccurate healthcare provider directories, which violated California’s Unfair Competition Law.

Groom Law Group, Chartered

In the healthcare insurer space, Groom Law Group, Chartered stands out for its focus on providing expert regulatory advice, advising its clients on all aspects of federal and state regulations concerning healthcare delivery services and insurers. In particular, the firm regularly advises major health insurance companies on Medicare coverage rules, HIPAA privacy requirements, and insurer responsibilities under the Mental Health Parity Act. Additionally, 2022 has seen the firm advising employers, insurers, and health plan administrators on the full range of legal implications arising from federal and state law changes in the wake of the Dobbs decision. Jointly led by Jon Breyfogle and Lisa Campbell, who both have significant government experience, the team is based in Washington DC. They are supported by ACA specialists Seth Perretta and Ryan Temme, whose work focuses on the requirements of the Mental Health Parity and Addiction Equity Act, as well as ACA compliance.

Practice head(s):

Jon Breyfogle; Lisa Campbell


Other key lawyers:

Ryan Temme; Seth Peretta


Latham & Watkins LLP

Latham & Watkins LLP‘s team combines a strong transactional practice with a focus on complex litigation. John Manthei and Ben Haas co-head the healthcare team from the Washington DC office, while fellow co-head Judith Hasko takes the lead from her base in San Francisco. On the litigation side, Gwyn Williams and David Tolley, both located in Boston, defend major insurers in a series of underpayment claims cases, while Washington DC’s Daniel Meron focuses on False Claims Act matters. Its transactional offering was further strengthened in October 2022 with the arrival of co-chair Jason Caron and Kevin Miller, both formerly at McDermott Will & Emery LLP. Based in Washington DC, Caron leverages clinical and government experience to advise clients on complex healthcare regulatory, reimbursement, and policy matters, while Chicago-based Miller’s practice focuses on advising private equity sponsors and portfolio companies on investment-related transactional healthcare insurance matters.

Practice head(s):

John Manthei; Judith Hasko; Ben Haas; Jason Caron; Eveline Van Keymeulen


Other key lawyers:

David Tolley; Gwyn Williams; Daniel Meron; Kevin Miller


Key clients

UnitedHealthcare


Aon Corporation


Oscar Health


Independent Healthcare Association


Molina Healthcare