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 ‘fantastic‘ John 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.
Health insurers in United States
Epstein Becker & Green, P.C.
Mark Lutes; George Breen
Other key lawyers:
Steven Epstein; John Gilbertson; Jackie Selby; Gregory Epstein; Kevin Malone; Jason Christ; Lynn Shapiro Snyder
‘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‘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.
Other key lawyers:
Robert Belford; Ileana Hernandez; Randi Siegel; Gregory Pimstone; Anne Karl; Michael Kolber; Paul Carr-Rollitt; Megan Thibaut-Ind; Stephen Libowsky
Ann & Robert H. Lurie Children’s Hospital of Chicago
City of New York/New York City Health + Hospitals Corporation
New York State Coalition of Anchor Safety Net Hospitals
North Carolina Department of Health and Human Services
Yale New Haven Health
Blue Shield of California
Memorial Sloan Kettering Cancer Center
California Department of Health Care Services
- 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.
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, Brian Stimson, and Eric Zimmerman, both in DC. Jason Caron and Kevin Miller left the firm in 2022.
Other key lawyers:
‘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.‘
‘Vernessa Pollard is a highly skilled healthcare attorney who provides excellent legal advice. She responds to inquiries very quickly and her guidance is practical: easily understood by laypersons. Anisa Mohanty also is a highly skilled healthcare attorney who provides excellent legal advice. She produces a high quality written product very quickly.’
Enhanced Healthcare Partners
St. Luke’s Health System
Devoted Health Plan
- 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 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.
Bruce Merlin Fried; Janice Ziegler
Other key lawyers:
Michael Barnes; Dianne Winter Brookins; Claire Bornstein;
- 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.
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.
Nancy E. Taylor; David Peck
Other key lawyers:
Tricia A. Asaro; Harold N. Iselin; Eileen M. Hayes; Joseph F. Coniglio; Elizabeth Sacco; Caroline Brancatella
‘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.’
Affinity Health Plan
MVP Health Care
MetroPlus Health Plan Inc.
Oscar Insurance Corporation
New York Health Plan Association
Longevity Health Founders
Texas Association of Health Plans
- 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‘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.
Other key lawyers:
Craig H. Smith; Michael Maddigan; Sheree Kanner; Jeremy Schneider; David Massey
‘Hogan Lovells have tremendous experience with Florida health laws, regulations, and relationships with key stakeholders.‘
‘They are very knowledgeable and fierce advocates.‘
Elevance Health (f/k/a Anthem)
Florida Association of Health Plans
Blue Cross and Blue Shield of Florida, Inc.
Anthem Blue Cross of California
- 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.
Other key lawyers:
Lee Blalack; Caitlin Bair; Stephen Sullivan
‘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.‘
BlueCross BlueShield of North Carolina
Cambia Health Solutions
Elevance Health, Inc. (f/k/a Anthem, Inc.)
Excellus Health Plan, Inc.
Health Care Service Corporation
Kaiser Foundation Health Plan
UnitedHealth Group and UnitedHealthcare Insurance Company
- 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.
Scot Hasselman; Kurt Peterson
Other key lawyers:
Marty Bishop; Kenneth Smersfeld; Rebecca Hanson
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.
Other key lawyers:
Lynsey Mitchel; Eric Newsom; Moe Keshavarzi; Christine Clements
‘Extremely knowledgeable and hard-working practice. Intelligent attorneys at all levels from junior associates to partners. The group is very collaborative.’
‘Knowledgeable and hardworking.’
Blue Shield of California (BSC)
SCAN Health Plan
Kaiser Foundation Health Plan, Inc
Honest Medical Group LLP
California Association of Health Plans
Physicians Medical Group of San Jose, Inc.
United Health and Kaiser Permanente
agilon health, inc.
Hawai’i Medical Service Association
Renal Payer Solutions, Inc.
- 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.
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.
Jon Breyfogle; Lisa Campbell
Other key lawyers:
Ryan Temme; Seth Peretta
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.
John Manthei; Judith Hasko; Ben Haas; Jason Caron; Eveline Van Keymeulen
Other key lawyers:
David Tolley; Gwyn Williams; Daniel Meron; Kevin Miller
Independent Healthcare Association