Firms To Watch: Healthcare: health insurers

Holland & Knight LLP has aggressively expanded its health insurer focused team this year, bringing in seven new partners to bolster its practice. Boston-based practice co-head Jeffrey Mittleman focuses on fraud and abuse cases, with an emphasis on anti-kickback statutes, and Jennifer Rangel advises on major transactions from Austin.

Healthcare: health insurers in United States

Epstein Becker & Green, P.C.

Nationally regarded for its focus on the broader healthcare market, Epstein Becker & Green, P.C. is also known for its excellent understanding of the health insurance sector. The team acts on behalf of insurers on transactions involving service providers, with experience advising multiple large-scale national insurers. It is also experienced in guiding payers through the implementation of value-based care systems, advising on reimbursement issues, and issues involving digital healthcare. The firm offers a deep bench of lawyers with previous government experience. Its litigation arm, led by practice co-head George Breen, acts on False Claims Act cases as well as major government investigations. Co-head Mark Lutes is experienced in advising private equity on their healthcare investments. Both are based in Washington DC. New York-based Jackie Selby offers expertise in matters of reimbursement as well as risk-sharing arrangements. DC-based Lynn Shapiro Snyder and Gregory Epstein are respective leaders in the third party payer sector and the government programs space.

Practice head(s):

Mark Lutes; George Breen;

Manatt, Phelps & Phillips, LLP

Buoyed by its client roster of national insurers, Manatt, Phelps & Phillips, LLP's full-service team, led by William Bernstein, has been active in the transactional market, advising both Humana and Canopy Health on acquisitions and the creation of new insurance projects. In relation to this, the team also provides antitrust services for health sector clients. Litigation is another area of expertise, with a particular emphasis on reimbursement cases. California-based John LeBlanc is a key name in the practice, with experience advising on the full range of insurer-related disputes, as well as advising managed care providers. New York-based Robert Belfort is regarded in the market for his combination of transactional and regulatory advice, while California-based Paul Carr-Rollitt advises on major transactions. Also well regarded are ACA expert Michael Kolber, Medicaid expert Ann Karl, and regulatory expert Randi Siegel, all of whom are New York-based.

Practice head(s):

William Bernstein

Testimonials

‘Manatt has a particular aptitude for hiring attorneys who have a wide range of skills. Beyond interpreting policy, crafting policy or recommending reaction to policy, the team leads the discussion in envisioning a collaborative future with policymakers.’

‘The individuals at Manatt demonstrate a personal commitment to service that is unique. Team members clearly communicate effectively, therefore on an individual basis as a client I can trust that individuals collectively execute in my interest.’

 

Key clients

City of New York

Humana

Vermont Agency of Human Services

SBH Health System

Tufts Health Plan

Dignity Health

Kaiser Foundation Health Plan

Canopy Health

Health Net

Blue Shield of California

California Department of Health Care Services

Memorial Sloan Kettering Cancer Center

Wyoming Medical Center

Alliance of Dedicated Cancer Centers

Center on Budget and Policy Priorities

Memorial Sloan Kettering Cancer Center

Children’s Hospital Association

Legion Healthcare Partners

Connecticut Health Foundation

Maine Department of Health and Human Services

Catholic Health Association of the United States

AARP

MultiCare Health System

Yale New Haven Health System

Oregon Health Authority/Department of Justice

Adirondack Health Institute

Medisys Health Network

Velano Vascular

Astiva Health

Brandman Health Plan

THT Health

St. Mary’s Medical Center

Work highlights

  • Represented the City of New York in the creation of a landmark loan fund to support safety-net hospitals throughout the Covid-19 pandemic.
  • Represented Humana in its acquisition of Kindred at Home.
  • Representing Dignity Health in a suit brought by the American Civil Liberties Union relating to binding ethical and religious directives for Catholic health care.

McDermott Will & Emery LLP

McDermott Will & Emery LLP offers a full slate of services for leading insurers and health networks. On the transactional front, the team expanded its private equity and venture capital work, advising groups such as Gigafund on their investments, and advising new insurance companies on working with venture capital groups. It also advised companies such as Ascension on the establishment of Medicare Advantage plans. Disputes are another area of expertise, with the team acting on claims cases, ERISA litigation and putative class actions. Particularly notable is the team’s regulatory and government advocacy team, with Washington DC-based partners Brian Stimson, Eric Zimmerman, Miami’s Jerry Sokol and DC’s Jason Caron providing support to healthcare trade organizations on the No Surprises Act. Jeremy Earl and Kate McDonald , also DC-based, provide strong regulatory support focusing on ACA compliance and government healthcare programs respectively. DC’s Ankur Goel is a well-respected litigator, and Gary Scott Davis leads transactions out of Miami. The team has also recently opened a new office in Atlanta.

Practice head(s):

Jerry Sokol

Testimonials

‘Kate McDonald and the MWE team have been truly exceptional. They’ve gone above and beyond for us, the client, at every step. They’ve been great at managing legal counsel with business savvy, which is not something every top law firm does well and they do a great job. Kate, in particular, is a unique individual who has earned the trust and admiration of our entire team. She’s a fantastic attorney and counselor.’

‘Kate McDonald is a unique legal partner. She works efficiently and comprehensively and she’s gone above and beyond at every step. She also knows her own core competencies and has the good judgment and humility to engage colleagues when it makes sense.’

Key clients

Aetna Sutter Insurance Company

Angle Health, Inc.

Ascension

Cigna

Geisinger

Gigafund

Work highlights

  • Represented Ascension in its joint venture with Centene to establish a leading Medicare Advantage plan.
  • Represented Aetna in a joint venture between Aetna and Sutter Health in the formation and licensing of a new health insurer in California.
  • Representing Cigna in multiple major multi-million and billion-dollar disputes.

Dentons

Dentons‘ health insurer platform offers a full suite of transactional, regulatory and litigation services befitting of an international firm. The firm is known for its work with managed care organisations, with particular experience advocating for health plans regarding CMS’ denial of Medicare Advantage Applications. Its Honolulu office is another unique feature of the firm’s practice, with partner Dianne Winter Brookins advising on insurance litigation in the unique Hawai’ian market. Washington DC-based practice co-head Janice Ziegler is known for her expertise on Medicare Secondary Payer laws, advising both payer and provider stakeholders on regulatory and contentious matters within that space. Also based in DC is co-head Bruce Merlin Fried, who brings previous experience as the director of managed care at the Centers for Medicare and Medicaid Services. Also recommended is New York associate Claire Bornstein, who advises on ACA issues, with an emphasis on childrens’ healthcare provision.

Practice head(s):

Janice Ziegler; Bruce Merlin Fried

Other key lawyers:

Dianne Winter Brookins; Claire Bornstein; Helen Reeves

Key clients

UCare

LA Care

Work highlights

  • Advised LA Care on federal government relations, health care regulatory and litigation matters.
  • Advised UCare on federal government relations and health care regulatory matters.

Greenberg Traurig LLP

Greenberg Traurig LLP acts for both national and regional insurers, combining regulatory and transactional services. It has a particular niche working with managed care plans, with Albany-based Harold N. Iselinserving as lead outside counsel to The New York Health Plan Association. Also on the regulatory front, the team is able to act on Medicare/Medicaid payment plan reviews, OIG Audits, and matters regarding accreditation. Private equity transactions mark another key strength of the team. It also offers contentious services out of its Dallas office, with Joseph Coniglio acting on government investigations and claims litigation. Nancy Taylor and David Peck lead the overall healthcare team from Washington DC and Fort Lauderdale respectively. Albany-based Tricia A. Asarois recommended for transactions.

Practice head(s):

Nancy Taylor; David Peck

Other key lawyers:

Tricia A Asaro; Harold N Iselin; Joseph Coniglio

Key clients

Affinity Health Plan

Centene Corporation

MVP Health Care

MetroPlus Health Plan Inc.

Oscar Insurance Corporation

United HealthCare

ProAssurance

Work highlights

  • Advised Affinity Health Plan in the company’s recent sale to Molina Healthcare, Inc.

Hogan Lovells US LLP

Hogan Lovells US LLP is known for its litigation services, acting for national insurers on civil and criminal cases. It offers particular expertise in class action matters, representing clients including UnitedHealthcare and Centene on challenges to coverage policies, ERISA cases and access denial matters. Claims cases, reimbursement disputes, and antitrust cases are other areas where the practice excels. Transactions are another piece of the team’s overall offering, acting for regional insurers on their dispositions and acquisitions. The Miami office is particularly noteworthy for its insurer focus, with notable lawyers there including Craig Smith, who acts on transactional matters, and David Massey, who advises Fortune 100 insurers on litigations. Los Angeles-based Michael Maddigan is another key litigator. Washington DC-based Ronald Wisor leads the overall group.

Practice head(s):

Ronald Wisor

Key clients

UnitedHealthcare

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 a number of class-action lawsuits across the country.
  • Represented Molina Healthcare in a breach of contract lawsuit with Mount Sinai Medical Center of Miami.
  • Represented Centene Corporate in a complex drug pricing class action lawsuit.

Morgan, Lewis & Bockius LLP

Morgan, Lewis & Bockius LLP is known for its complex contentious work, with an emphasis on representing large scale, national health plans. Class actions are a particular area of strength for the team, having achieved victories either through litigation or settlement on behalf of Anthem and Cigna. It is equally capable of acting in reimbursement disputes with providers, and in appellate cases. The team also acts on insurer financings, with Philadelphia-based Stephen Janetta advising Independence Health Group on its $550m credit facility. San Francisco-based Molly Moriarty Lane is particularly well regarded for her class action work and expertise on the Mental Health Parity Act. Brian Jazaeri and Howard Young co-lead the team from Los Angeles and Washington DC respectively. LA-based Lisa Weddle also offers class action expertise.

Practice head(s):

Howard Young; Brian Jazaeri

Key clients

MD Anderson Cancer Center

Centennial Hospice

Gastro Care Partners

Ready Responders

The Vistria Group

Agape Care Hospice

Clinical PsychAssociates LLP

Indigenous Pact, Inc.

DaVita, Inc.

Rite Aid

Work highlights

  • Represented Anthem in several behavioural health class action cases.
  • Represented Cigna in putative nationwide RICO and ERISA class action.
  • Represented Independence Health Group and certain of its subsidiaries in a $550m five-year syndicated credit facility.

O'Melveny & Myers LLP

The team at O’Melveny & Myers LLP is praised by clients as ‘exceptional in every way’, with the team offering particular strength on contentious matters. It is experienced in both civil and criminal cases, offering expertise on false claims act cases, state and federal government inquiries and class action cases. Notably, it has acted for a consolidated group of Kaiser Permanente plans on 6 False Claims act cases worth over $1bn. The team is led by David Deaton, who is based in Newport Beach and offers regulatory support. Lee Blalack heads the Washington DC-based litigation practice and is known for representing Anthem, Humana and OptumRx. San Francisco-based Caitlin Bair is also recommended for representing managed care organizations.

Practice head(s):

David Deaton

Other key lawyers:

Lee Blalack; Caitlin Bair

Testimonials

‘The OMM team is exceptional in every way. They are handling a very complicated matter for us, and have been strategically and practically amazing to work with. The team provides high-quality legal advice in a very user-friendly way irrespective of whether they are dealing with lawyers, the C-Suite or our frontline staff. ‘

‘David Deaton has led the team for years. His advice and customer services are top-notch, but more importantly, he runs a very large team that consistently performs well top to bottom.’

‘I uniformly am impressed by each member of the team, who all perform exceptionally at their level, and often well above their level.’

Key clients

Anthem, Inc.

Cambia Health Solutions

Clover Health

Health Care Service Corporation

Humana Inc.

Johnson & Johnson and Janssen Pharmaceuticals

Kaiser Foundation Health Plan

Molina Healthcare

UnitedHealth Group and UnitedHealthcare Insurance Company

Work highlights

  • Representing Kaiser Foundation Health Plan companies in six consolidated False Claims Act qui tam actions and a DOJ intervention complaint.
  • Representing Anthem, Inc in civil investigative demands into Anthem’s Medicare Advantage risk adjustment practices
  • Representing UnitedHealth Group in Gozdenovich v. AARP, a putative class action brought against the client.

Reed Smith LLP

Reed Smith LLP provides cradle to grave services for its clients, with an emphasis on litigation, regularly acting on nationally-significant matters, including class actions, government investigations, ERISA cases and statutory claims. It also has a strong understanding of risk arrangements, from the negotiation stage through risk corridor-based litigation. Century City-based practice head Kurt Peterson is known for his work with managed care organizations, managing a full slate of contentious matters on their behalf. Chicago-based Marty Bishop is also an experienced trial litigator, with an emphasis on ERISA class actions, provider disputes and member disputes. Also recommended are Los Angeles-based managed care expert Kenneth Smersfelt and Chicago-based ACA-expert Rebecca Hanson.

Practice head(s):

Scot Hasselman; Kurt Peterson

Other key lawyers:

Marty Bishop; Kenneth Smersfelt; Rebecca Hanson

Gibson, Dunn & Crutcher LLP

In the health insurer space, Gibson, Dunn & Crutcher LLP is known for its advocacy efforts in class action and antitrust matters. Its most notable client is industry giant UnitedHealthGroup, for whom it acts on a number of different cases. The team also has experience acting for Aetna, with experienced Los Angeles-based partner Richard Doren representing them in a number of civil litigations. Also based in LA is Heather Richardson, who adds expertise in domestic and international arbitrations to her litigation practice.

Other key lawyers:

Richard Doren; Heather Richardson

Key clients

UnitedHealth Group

Groom Law Group, Chartered

The Washington DC-based healthcare team at Groom Law Group, Chartered prioritizes expert regulatory advice, covering Medicare coverage rules, HIPAA privacy requirements, and insurer responsibilities under the Mental Health Parity act. The team has been heavily involved in telehealth-related work, advising a number of health plan sponsors on adding telehealth aspects to their offerings. It also offers transactional support, advice on federal investigations and anti-kickback cases, as well as growing advice related to the federal No Surprises Act. Jon Breyfogle and Lisa Campbell co-lead the team, both bringing with them prior leadership experience in federal bodies. Ryan Temme is also recommended for his work on government audits on requirements of the Mental Health Parity and Addiction Equity acts.

Practice head(s):

Jon Breyfogle; Lisa Campbell

Other key lawyers:

Ryan Temme; Seth Peretta

Jones Day

Jones Day‘s ‘very knowledgeable' team focuses on regulatory and transactional work, with the team particularly known for its clinical integration expertise and value-based care advice. Much of its work is with regionally focused networks, taking advantage of its large network of offices. The team is co-led by three attorneys, Washington DC-based Alexis Gilroy and Kenneth Field, and Chicago-based Heather O’Shea. Columbus-based Lisa Han is known for her transactional work, and San Francisco-based David Morris acts on employer/payer contracting matters. Dallas's Kurt Copper offers contentious support to clients.

Practice head(s):

Alexis Gilroy; Kenneth Field; Heather O’Shea;

Other key lawyers:

Lisa Han ; David Morris ; Kurt Copper

Testimonials

‘This team is very knowledgeable about the health care insurance regulations in Ohio, but also nationwide. They have worked on projects and given us usable tools to allow us to run our business. Other law firms were not able to provide the tools we needed. They have also assisted us with regulatory filings and communications with the regulators on several critical projects.’

‘The Jones Day team, especially Lisa Han, is very responsive and available for consultation. the quality of work is top-notch. I always feel very confident in the legal advice provided. It is thorough and concise, at the same time.’

Key clients

Prisma Health

Stanford Health Care

Work highlights

  • Advised Prisma Health on the formation of a value-based clinically integrated care network in South Carolina.
  • Represented Stanford Health Care in connection with the development and negotiation value-based payment arrangements with multiple employer plans.

Latham & Watkins LLP

Latham & Watkins LLP provides a combination of high value transactional and complex litigation services to its clients. For transactions, the team is equally skilled with capital markets work, where it acted as counsel to Oscar Health in its $1.5bn IPO, and M&A, where it counselled AON on its proposed merger with Willis Towers Watson. In litigation, Boston-based Gwyn Williams and David Tolley are acting for UnitedHealth Group in a series of out-of-network underpayment claims in Arizona. Washington DC-based Daniel Meron brings expertise in False Claims Act cases, and Los Angeles-based Daniel Settelmayer offers regulatory and transactional advice to his clients. The overall healthcare group is led by John Manthei and Judith Hasko, based in DC and Silicon Valley respectively.

Practice head(s):

John Manthei; Judith Hasko

Other key lawyers:

Gwyn Williams; David Tolley; Daniel Meron; Daniel Settelmayer

Key clients

Aon

Cigna

GoHealth, Inc.

Independent Health Association

Lemonade

Molina Healthcare

Mulberry Health, Inc.

Oscar Health, Inc.

UnitedHealth Group

Work highlights

  • Represented Oscar Health in its $1.5bn initial public offering.
  • Advised Lemonade in its follow-on offering of 4,824,314 Shares of Common Stock listed on the NYSE.
  • Representing UnitedHealth Group, Inc. in an ongoing False Claims Act litigation related to UnitedHealth’s Medicare Advantage plans.

Sheppard, Mullin, Richter & Hampton LLP

Sheppard, Mullin, Richter & Hampton LLP continues to expand its presence in the healthcare space, particularly regarding insurance-related transactions. Risk contracting-based arrangements are a particular area of expertise for the team, as is the establishment of value-based care arrangements. It also acts on major M&A, serving as healthcare regulatory counsel to Cigna in its acquisition of telehealth provider MDLive. Much of the team is based in Century City, and as such, it has a strong presence in the California market. Eric Klein leads the team, offering major experience in market consolidation. Lynsey Mitchel focuses on HMO licensing advice, and San Francisco-based Eric Newsom advises on health tech.

Practice head(s):

Eric Klein

Other key lawyers:

Lynsey MitchelEric Newsom

Key clients

Blue Cross and Blue Shield of North Carolina

Newlight Partners

Stanford Health Care Advantage, Inc.

Blue Shield of California

Mutual of Omaha

Dignity Health

Unum Group

Kaiser Foundation Health Plan of Washington

Blue Cross Blue Shield of Kansas City

Bright Health

Cambia Health Solutions

CareFirst

CareMore Health (Anthem Subsidiary)

Centene Corporation

Cigna Corporation

Delta Dental

Dignity Health

Emblem Health

Fidelis Care corporate members

Fresenius

Harvard Pilgrim Health Care

Healthfirst

HealthNow of New York

Hawaii Medical Service Association

Molina Healthcare

Premera Blue Cross

Providence Health & Services

SCAN Health Plan, Inc.

Work highlights

  • Advised Cigna in its 2021 multi-billion-dollar acquisition of leading telehealth provider MDLive.
  • Represented Molina Healthcare, Inc. in its acquisition of Magellan Complete Care from Magellan Health, Inc.
  • Represented Cambia Health Solutions in its sale of HealthSparq, Inc. to Kyruus, Inc.