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Healthcare: health insurers in United States

Epstein Becker & Green, P.C.

Epstein Becker & Green, P.C. advises on a full range of contentious and non-contentious matters for insurers and clients facing insurer-related issues. The group is able to draw upon the experience of team members who have previously held positions in various federal agencies, and also has deep familiarity with the service provider side of the market. Additionally, the group is further differentiated by its strength in case litigation arising from healthcare investigations, as well as its experience working with innovative market practices, such as telehealth. Co-head George Breen focuses on litigation, with experience defending clients against claims of healthcare fraud and violations of the False Claims Act. In addition to his experience handling hospital mergers and antitrust suits, practice co-head Mark Lutes also has experience of healthcare investment transactions and policy issues. Gregory Epstein is also recommended. All named lawyers are based in Washington DC.

Practice head(s):

Mark Lutes; George Breen

Other key lawyers:

Gregory Epstein; Lynn Snyder; Jackie Selby

Manatt, Phelps & Phillips, LLP

Leveraging a multi-disciplinary approach with expertise in advocacy and policy matters, Manatt, Phelps & Phillips, LLP has maintained its reputation as a leader in the US healthcare market. In particular, the group has played a key role in helping companies and state healthcare systems respond to the demands of the Covid-19 pandemic. The growing team is led by experienced practice head William Bernstein, a go-to name for strategic advisory and consulting-style services. The firm's success has been driven by both new and existing business, with over 200 new clients to show during the review period. Robert Belfort is recommended for his expertise in regulatory compliance, and Randi Siegel is a name to note on the more junior end of the practice. Siegel advises public and private sector clients, including Humana and the State of New Jersey, on myriad regulatory issues. Gregory Pimstone in Los Angeles is recommended for healthcare litigation. Named lawyers are based in New York unless stated otherwise.

Practice head(s):

William Bernstein

Other key lawyers:

Robert Belfort; Randi Siegel; Gregory Pimstone

Testimonials

‘Manatt is my go-to firm because the attorneys are top-notch and leverage their expertise to help clients understand both legal and policy implications. The attorneys at Manatt are efficient in their work and provide thoughtful, client-centered feedback. I believe Manatt stands out from other firms because of their understanding of the health care industry as a whole and not just one sliver of it.’

‘Manatt are able to provide informed advice quickly. If they don’t know the answer immediately, they have a team capable of providing information back timely. This is wonderful support from outside counsel.’

‘Extraordinary knowledge and experience applicable to the area of focus we asked them to help us with – what is happening across the country with health systems and managed care organizations working in the area of social determinants of health. Manatt has been involved in most if not all of the truly innovative work that is going on in this arena.’

‘The healthcare practice lawyers at Manatt, Phelps, and Phillips LLP are very knowledgeable about all aspects of the industry but they still take the time to learn as much as they can about their clients. Their diligence helps them provide legal advice carefully tailored to a client’s particular need.’

‘Randi Seigel is an outstanding attorney – and is managerial brave. She gives you a straight answer which assists me in managing my client and also in getting work done. Randi is also good in the grey; she has experience being in-house and therefore can handle a large variety of issues. she also makes sure each matter is followed-up timely.’

Key clients

NYC COVID-19 Rapid Response Coalition

CVS Health

New York Care Information Gateway

Mount Sinai Health System

Memorial Sloan Kettering Cancer Center

Medicaid Health Plans of America

New York City Health + Hospitals

Humana

Robert Wood Johnson Foundation

American Hospital Association

Yale New Haven Health System

State of New Jersey

State of Rhode Island

University of Iowa Health System

HCR ManorCare

Canopy Health

Blue Shield of California

Caption Health

Kaiser Foundation Health Plan

Dignity Health

Teachers Health Trust (THT Health) and Teachers Emergency Assistance & Community Health, Inc. (TEACH)

Eko Devices

St. Mary Medical Center

FitBit

Association of California Life and Health Insurance Companies

Astiva Health

Brandman Health Plan

Work highlights

  • Co-founded the NYC Covid-19 Rapid Response Coalition alongside New York Healthcare leaders, providing strategic support and subject matter expertise on Medicaid and uninsured populations.
  • Represented Dignity Health in a Supreme Court Case concerning first amendment freedom of religion and transgender issues for faith-based medical practices.
  • Advised Wyoming Medical Center, the largest hospital in the state, on its complex strategic affiliation transaction with Banner Health.

McDermott Will & Emery LLP

The deeply experienced team at McDermott Will & Emery LLP provides transactional and regulatory advice to health insurers, while also representing healthcare-sector clients in enforcement proceedings and litigation. The firm has a strong background working with private equity clients and has advised a variety of non-traditional investors on health insurance transactions. It is also noted for its focus on digital health issues. Moreover, the litigation team, was recently bolstered by the arrivals of three new partners from Kirkland & Ellis LLP, in a move that significantly strengthens the firm's litigation capabilities for health insurers. Eric Zimmerman leads the team from Washington DC, with a focus on policy and legislation matters. Other names to note in Washington DC are Jeremy Earl, who focuses on regulation relating to managed care organizations, and Kate McDonald, who advises insurers and HMOs on a full range of federal and state regulatory matters.

Practice head(s):

Eric Zimmerman

Other key lawyers:

Jeremy Earl; Kate McDonald

Key clients

Ascension

Benefytt Technologies, Inc.

Blue Cross Blue Shield of Tennessee

Cigna

DaVita Inc.

Florida Blue

Health First

RWJBarnabas Health

Work highlights

  • Acted as healthcare regulatory counsel to Benefytt Technologies, Inc., a distributor of Medicare-related health plans, in connection with a $410m take-private transaction with MadisonDearborn Partners.
  • Represented Cigna in a series of putative class actions challenging Cigna’s use of American Specialty Health(ASH), with more than $200m at stake.
  • Representing RWJBarnabas Health in its acquisition of a minority interest in Braven Health, an insurance company offering Medicare Advantage coverage in New Jersey in 2021.

Dentons

Dentons fields a well-balanced healthcare team, with attorneys able to handle a breadth of transactional, regulatory and litigation-based work. It has strong knowledge and understanding of a variety of Affordable Care Act (ACA) issues, particularly relating to accountable care organizations. Washington DC-based practice co-head Janice Ziegler handles significant amounts of speciality work focusing on Medicare Secondary Payer (MSP) laws, providing counsel to insurers, service providers, employers and industry associations. Also in Washington DC, joint practice head Bruce Merlin Fried has significant experience in healthcare law and policy, with a background in both public and private sector work.

Practice head(s):

Janice Ziegler; Bruce Merlin Fried

Other key lawyers:

Dianne Brookins; Helen Reeves; Todd Daubert

Testimonials

‘This team is pleasant to do business with, which is most important to me. The advice is top-notch and very practical, they push back when needed, they apologize for mistakes and use a diverse workforce to get the job done.’

‘Helen Reeves is a problem solver – she knows when to let her team do the work, but also when to step in and adjust or guide the team as needed. She is very responsive to client needs and mentors her team as needed.’

‘Todd Daubert responds very quickly, galvanizes other team members to get large projects done, takes responsibility for mistakes and gives credit for good work, and goes out of his way to create a fun working relationship.’

Key clients

Hannover Life Reassurance Company of America

Boston Medical Center Health Plan

Work highlights

  • Provided counsel to LA Care on federal government relations, healthcare regulatory and litigation matters.
  • Provided counsel to UCare on federal government relations and healthcare regulatory matters.
  • Provided counsel to Hannover Life Reassurance Company of America in connection with healthcare regulatory matters.

Greenberg Traurig LLP

Greenberg Traurig LLP's healthcare and FDA practice handles regulatory and transactional work for a variety of standout clients, including Centene, Oscar Insurance and United Healthcare. In particular, the team has an emphasis on transactions involving private equity firms and other private investors. Standout work in this area included serving as counsel to long-standing client Affinity on its pending sale to Molina Healthcare; that matter was led by Albany-based attorneys Harold Iselin and Tricia Asaro. In the regulatory space, the team undertakes regular reviews of Medicare and Medicaid payments, OIG audits and sanctions, and state licensure and accreditation. The practice group is jointly led by Nancy Taylor in Washington DC and David Peck in Fort Lauderdale. Eileen Hayes is also  recommended in the Albany office.

Practice head(s):

Nancy Taylor; David Peck

Other key lawyers:

Harold Iselin; Tricia Asaro; Eileen Hayes

Key clients

Affinity Health Plan

Centene Corporation

MVP Health Care

MetroPlus Health Plan Inc.

Oscar Insurance Corporation

Riseboro Community Partnership

United HealthCare

ProAssurance

Work highlights

  • Served as counsel for long-time client Affinity in the company’s recently announced pending sale to Molina Healthcare, Inc.

Hogan Lovells US LLP

Hogan Lovells US LLP has a strong track record in class actions, fraud and abuse litigation, routinely acting for market-leading health insurers. Of recent note, Miami-based attorneys Craig Smith and David Massey defended Centene in a state-wide putative class action suit concerning adequate access to certain prescriptions; the case ended in dismissal and a later resolution between the parties. Other key clients include United Healthcare and Anthem, which the firm represents in ERISA litigation, arbitration and general business disputes, among other matters. Michael Maddigan leads the Los Angeles litigation practice, and is recognized for his experience in class actions, False Claims Act cases, and internal investigations. In addition to its focus on high-stakes litigation, the team also advises on transactional matters and compliance, antitrust and privacy issues. Sheree Kanner leads the practice group from Washington DC.

Practice head(s):

Sheree Kanner

Other key lawyers:

Craig Smith; Michael Maddigan; David Massey

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 various class action lawsuits across the country, including Florida and California, successfully resolving the matters in favor of the client.
  • Represented Anthem Blue Cross in various matters.
  • Resolved a complex class-action lawsuit brought on behalf of individuals who allege that the policies of Centene improperly denied them access to certain prescription drugs for Hepatitis C.

Morgan, Lewis & Bockius LLP

The team at Morgan, Lewis & Bockius LLP is best known for representing large healthcare plans and providers in complex litigation and class action lawsuits. Jointly led by insurance practice leader Brian Jazaeri and Washington DC-based Howard Young who manages the healthcare practice, the practice group marries industry experience with a wide range of general insurance expertise to provide comprehensive service from different angles. Other key figures in the team include Lisa Weddle and San Francisco-based Molly Moriarty Lane, both of whom represent well-known insurers in large class actions, and Taylor Day, a standout associate in the team who is building a solid reputation in the area of class actions. Named lawyers are based in Los Angeles unless stated otherwise.

Practice head(s):

Howard Young; Brian Jazaeri

Other key lawyers:

Molly Moriarty Lane; Taylor Day; Lisa Weddle

Testimonials

‘The Morgan Lewis health insurers practice is a great firm to work with. They understand the needs of insurer clients and are extremely responsive. The team in California is especially strong in an area where health insurers face a daunting range of issues. In particular, they provide their clients with standout advice on reimbursement issues and provider billing practices which will have implications across the state.’

‘Brian Jazaeri is a great lawyer to work with. We have worked with Brian for many years and he is always able to find us creative solutions to any legal issues we are facing. He is one of the leading lawyers in California in healthcare litigation and a fierce advocator for us in our litigation related matters.’

Key clients

Anthem Inc.

Cigna

Health Net of California, Inc. (Centene)

Blue Cross Blue Shield of Massachusetts

Molina

Optum

Work highlights

  • Acted for Anthem Inc. in several behavioral health class action cases.
  • Acted for Cigna in a class action case alleging that Cigna violated California’s Unfair Competition Law and False Advertising Law.
  • Representing Health Net in litigation brought by Cedars-Sinai Medical Center regarding the reimbursement for Medi-Cal claims under California law.

Reed Smith LLP

Reed Smith LLP has a strong focus on litigation, representing high-profile clients in a variety of suits, including class actions, ERISA investigations, and bad faith, breach of contract and statutory claims. The team has particular strength in managed care plans—a focus area for Century City-based practice co-head Kurt Peterson—having won multiple high-stakes cases in the field. Marty Bishop in Chicago and Kenneth Smersfelt in Los Angeles have strong experience working with managed care organizations. Also recommended in Chicago is Bryan Webster, who handles fraud and abuse-related work for medical laboratories and other clients.

Practice head(s):

Scot Hasselman; Kurt Peterson

Other key lawyers:

Marty Bishop; Kenneth Smersfelt; Dan Hofmeister; Brian Webster

Testimonials

‘The managed care team is knowledgeable about all aspects of our business from litigation by providers and subscribers, to insurance recovery, to technology, to government contracts, to fraud and abuse, to particular employment issues, and so forth. The number of clients in the area and the number of lawyers servicing this area make them the go-to law firm for managed care in my estimation.’

Gibson, Dunn & Crutcher LLP

Gibson, Dunn & Crutcher LLP focuses on litigation in this space, representing healthcare companies and insurers in state and federal courts across the country. Recent highlights include defending UnitedHealthcare in two cases: the first, a dismissal of a challenge to its relationship with a third party, and the other, an ongoing defense in a putative class action case concerning its review of in-patient mental health services. Leading these two cases is Los Angeles-based attorney Heather Richardson, who also has expertise in reimbursement policy, provider fraud, coverage determinations, and quality of care. Also recommended in Los Angeles is Richard Doren, who has extensive experience in class actions, novel bad faith disputes, and other high-stakes coverage disputes.

Other key lawyers:

Heather Richardson; Richard Doren

Key clients

UnitedHealth Group

Work highlights

  • Represented United Healthcare in a challenge to its contractual relationship with a third party, Viant, and its methodology for reimbursing out-of-network providers.
  • Represented  United Healthcare n putative class action challenge to United’s utilization review of inpatient mental health services.

Groom Law Group, Chartered

Based in Washington DC, the team at Groom Law Group, Chartered handles a full range of contentious and non-contentious matters, and has focused on expanding its existing work managing the impact of the ACA on both employers and insurers. The firm also stands out for its specialized knowledge of HIPAA privacy and security issues, healthcare tax law. Practice co-heads Jon Breyfogle and Lisa Campbell have extensive careers working in government, giving them unique insight into the navigation of client relationships with state and federal agencies, and the development of compliant products. Seth Peretta and Ryan Temme are also recommended for their state and federal compliance work.

Practice head(s):

Jon Breyfogle; Lisa Campbell

Other key lawyers:

Seth Peretta; Ryan Temme

Jones Day

Jones Day has broad expertise in issues facing the healthcare industry, routinely advising on M&A and joint ventures in the sector, fraud and abuse regulation, antitrust, digital health issues, and corporate governance. Working in conjunction with other of the firm's practice groups, the team is able to provide comprehensive support on matters ranging from private equity transactions to bankruptcies and multi-jurisdictional disputes. Notable work includes representing The Peoples' Choice Hospital in a civil suit initiated by Aetna over damages from rural reference lab programs. The team is jointly led by San Francisco-based James DutroStephen Sozio in Cleveland, and Kenneth Field in Washington DC. Lisa Han in Columbus, Ohio has extensive experience in managed care negotiations and regulatory matters, and San Francisco-based David Morris is a name to note for transactions between healthcare payers and providers.

Practice head(s):

James Dutro; Stephen Sozio; Kenneth Field

Other key lawyers:

Lisa Han; David Morris

Key clients

The People’s Choice Hospital

Work highlights

  • Advised People’s Choice Hospital (PCH), which was sued by Aetna in a civil RICO action in federal court in connection with a reference lab program that PCH operated in rural hospitals.

Latham & Watkins LLP

Latham & Watkins LLP represents a variety of national insurers and locally oriented health plans, with a particular emphasis on regulation, government investigations and litigation. The team provides regulatory advice to multiple payers, with notable clients including UnitedHealthcare, Molina Healthcare, and AON. In addition, the team benefits from the government experience of its partners, with several attorneys having worked in multiple previous presidential administrations. Daniel Meron had a particularly standout year, with multiple successful defenses of United Healthcare in FCA claims and other regulatory challenges.

Practice head(s):

John Manthei; Judith Hasko; Brian Cuneo; Michael Morin; Terra Reynolds

Other key lawyers:

Daniel Meron

Key clients

UnitedHealthcare

Health Net

Molina Healthcare

SCAN Health Plan

Aon Corporation

Sutter Health

Independent Healthcare Association

Work highlights

  • Represented UnitedHealthcare in its successful challenge to a rule addressing how the Medicare and Medicaid programs pay insurance companies that participate in the Medicare Advantage program.
  • Representing United Healthcare in a False Claims Act dispute alleging that the nation’s largest Medicare Advantage organization submitted inaccurate information and allegedly received higher risk adjustment payments.
  • Represents Independent Health Association in a multi-defendant qui tam False Claims Act action regarding Independent Health Association’s risk adjustment diagnostic coding practices.

O'Melveny & Myers LLP

Specializing in False Claims Act defense and other litigation, O'Melveny & Myers LLP has a very experienced team and an enviable client base including Anthem, Humana, KaiserPermanente and UnitedHealthcare. Most notably in the review period, the team represented Health Care Service Corporation in an unpaid risk corridor case, and has also continued its representation of UnitedHealth Group in an ERISA class action case, both with significant estimated valuations. Key figures in the team are experienced attorneys Lee Blalack, who specializes in litigation; Brian Boyle, a name to note for ERISA class actions; and David Deaton, who leads the practice group from Newport Beach. The team has also invested heavily in its internal technological infrastructure, including data science and AI-based information systems, in order to improve team efficiency.

Practice head(s):

David Deaton

Other key lawyers:

Jim Bowman; Lee Blalack; Brian Boyle

Testimonials

‘The infrastructure of the firm is very strong allowing them to be nimble and have access to all resources needed for superior legal representation.’

Key clients

Anthem, Inc.

Blue Cross Blue Shield Association

Clover Health

Excellus Health Plan, Inc.

Health Care Services Corporation

Humana Inc.

Kaiser Permanente

Molina Healthcare

UnitedHealth Group and UnitedHealthcare Insurance Company

Work highlights

  • Represented Health Care Service Corporation (HCSC) at the Federal Court of Claims, resulting in a $2bn award for HCSC for unpaid risk corridors payments related to the Affordable Care Act.
  • Represented UnitedHealth and its affiliates in Peterson, D.C., et al v. UnitedHealth Group, Inc., et al., a long-running nationwide ERISA class action challenging the procedures used to recover overpayments to health care providers.

Sheppard, Mullin, Richter & Hampton LLP

The growing team at Sheppard, Mullin, Richter & Hampton LLP has expanded its focus on healthcare transactions, having recently been involved in several significant structured collaborations and M&A. The firm's expertise in transactions and risk arrangements involving Medicare Advantage plans, led by practice head Eric Klein, has been a key feature in its major cases. Other key figures include Lynsey Mitchel, who is recommended for her experience in HMO licensing, and Eric Newsom, a name to note for healthcare transactions and M&A. The firm has also stood out for its diversity initiatives, receiving multiple recognitions from clients and external bodies.

Practice head(s):

Eric Klein

Other key lawyers:

Lynsey Mitchel, Christine Clements, Eric Newsom

Key clients

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

Hawai’i Medical Service Association

Molina Healthcare

Premera Blue Cross

Providence Health & Services

SCAN Health Plan, Inc.

Work highlights

  • Acting for Molina Healthcare, Inc. in its $850m acquisition of the Magellan Complete Care business from Magellan Health, Inc.
  • Worked with Cigna to design and implement a partnership with Oscar, a tech-driven health insurance company, that will offer commercial health solutions to small businesses with 1 to 50 employees.
  • Assisted Brand New Day, a Medicare Advantage health plan in California, with its sale to Bright Healthcare.