Grounded in its insurance expertise, Gibson, Dunn & Crutcher LLP regularly represents insurers in False Claims Act and Anti-Kickback Statute matters, risk-adjustment and reimbursement disputes, and coverage and payment litigation. This includes parallel civil, criminal, and administrative proceedings, as well as national class actions and bad-faith claims. The practice is jointly led by Geoffrey Sigler in the Washington, D.C., office, who focuses on insurer-side litigation and advisory work involving ERISA, the Affordable Care Act, Medicare, and False Claims Act matters; and Los Angeles-based Deborah Stein, who excels in litigation involving insurance coverage and business-practices disputes. Also in the Los Angeles office, Heather Richardson is a go-to for advice on reimbursement policy and coverage determinations, and Richard Doren represents health insurers and plan administrators in federal and state courts. Winston Chan is a key contact for advice on FCA and healthcare fraud enforcement matters in the San Francisco office.
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Accolades
Client satisfaction: Lawyer & team quality
Client satisfaction: Billing & efficiency
Client satisfaction: Sector knowledge
Client satisfaction: NPS ®
Key clients
- PacifiCare Life and Health Insurance Company
- United Behavioral Health
- Inland Empire Health Plan
Work highlights
Assisted PacifiCare with vacating the Insurance Commissioner’s $173,603,750 penalty against PacifiCare Life and Health Insurance Company.
Retained by United Behavioral Health to reverse adverse rulings and curtailed the use of “reprocessing” as a remedy in ERISA class actions.
Representing UnitedHealth Group and its subsidiaries, OptumRx, Inc. and Emisar Pharma Services, LLC, in connection with an FTC investigation and enforcement action targeting the Pharmacy Benefit Management industry.
Practice head
Deborah Stein; Geoffrey Sigler
Other key lawyers
Heather Richardson; Winston Chan; Richard Doren