Under the direction of William Bernstein, Manatt, Phelps & Phillips, LLP remains a go-to for some of the biggest players in the healthcare space for comprehensive insurance-related counsel. The team handles complex commercial, transactional, regulatory, and litigious issues, such as M&A, joint ventures and vertical integrations, and Medicare Advantage marketing and Medicaid matters. New York-based Robert Belfort focuses on state and federal compliance and transactional advice, with extensive experience assisting clients with the Affordable Care Act, various Medicare issues, HIPAA portability and non-discrimination mandates, market conduct laws, and Medicaid managed care requirements. Trial and appellate litigator Greg Pimstone, who practices from Los Angeles, handles class actions filed against insurers and guides clients through government investigations. Also in LA, litigator Ileana Hernandez handles enforcement actions, unfair competition, bad faith, and ERISA suits among others. In New York, Randi Seigel is a key contact for emerging health tech and services companies, as well as a host of women’s health organizations, and Paul Carr-Rollitt’s core practice pivots between transactional and regulatory counsel. Another point of contact for clients in NYC is Helen Pfister, whose experience spans federal drug programs. Michael Kolber contributes his professional experience in government to the practice.
Health insurers in United States
Manatt, Phelps & Phillips, LLP
Responsables de la pratique:
Bill Bernstein
Autres avocats clés:
Robert Belfort; Greg Pimstone; Ileana Hernandez; Randi Seigel; Paul Carr-Rollitt; Helen Pfister; Michael Kolber; Rachel Sher; Adam Finkelstein
Principaux clients
Health Net
Aetna Life Insurance Company
Blue Shield of CA
UCLA Health
Canopy Health
New York e-Health Collaborative
Welbe Health
Bayada Home Health Care
Molina Healthcare
Pfizer
Principaux dossiers
- Represented Health Net in connection with a state court action filed by out-of-state substance abuse treatment facilities to recover additional reimbursement for services the facility allegedly rendered to Health Net insureds. In January 2023, the trial court ruled that the treatment facilities were not entitled to recovery on any of their claims, based on the substantial evidence of the providers’ fraudulent conduct that infected all claims.
- Defending Aetna Life Insurance Company in an ERISA class action brought by Andrew Howard alleging that Aetna wrongfully denies coverage for lumbar artificial disc surgery on the grounds that it is experimental and investigational.
- Obtained summary judgment and then affirmance on appeal in a lawsuit alleging improper denial of coverage, namely that Blue Shield of California failed to pay benefits for two members who were injured in an accident while traveling in Costa Rica.
McDermott Will & Emery LLP
McDermott Will & Emery LLP covers a broad array of healthcare matters, including a stream of large-scale M&A deals and complex restructurings, federal investigations, and complex disputes. Managed care organizations, not-for-profit providers, VC funds, and PE firms as well as cornerstones of the health insurance market routinely turn to the sizable team, which is led by Miami-based Jerry Sokol and includes DC-based Jeremy Earl, who is reputed for his transactional work, complex regulatory counseling, and advice on launches of new managed care arrangements. Also in the DC office is Kate McDonald, who specializes in federal program engagement, advising clients in connection to Medicaid Managed Care and various areas of Medicare, and back in Miami, Gary Davis tackles work in the field of managed care. Based in New York, Gregory Mitchell‘s practice spans managed care and reimbursement matters, Mary Moll Alexandre specializes in managed care in DC, and over in Boston, Matthew Perreault is a key contact for complex transactions, value-based care arrangements, and fraud and abuse. Chicago-based Monica Wallace focuses on delivering regulatory and transactional guidance, as does Brad Dennis.
Responsables de la pratique:
Jerry Sokol
Autres avocats clés:
Jeremy Earl; Kate McDonald; Gary Davis; Gregory Mitchell; Mary Moll Alexandre; Matthew Perreault; Monica Wallace; Brad Dennis
Les références
‘McDermott has broad and deep expertise in health care regulatory law. When I receive advice from McDermott, I’m confident it reflects significant experience and expertise in handling similar issues for peer companies. I also greatly appreciate their pragmatism and focus on problem-solving and risk evaluation.’
‘The team is knowledgeable, experienced, creative, committed to getting the job done, and wonderful to work with.’
‘The healthcare team at MWE is heads and tails above other firms I’ve worked with. Not only do they have the expertise within niche pockets of healthcare and M&A law, but their practice breadth combined with the ease at which they work cross-group makes them an exceptionally effective partner to us.’
Principaux clients
Ascension
Capital District Physician’s Health Plan (CDPHP)
CVS Health
Deerfield Management
Froedtert Health
Geisinger Health
Sentara Health
Principaux dossiers
- Assisting Capital District Physician’s Health Plan (CDPHP), a physician-founded not-for-profit health plan with USD 2.9 billion in revenue on its affiliation with The Lifetime Healthcare Companies, the parent company of Excellus BlueCross BlueShield and Univera Healthcare.
- Advising Deerfield Management on its joint venture with Horizon Blue Cross Blue Shield of New Jersey, the state’s only licensed Blue Cross Blue Shield plan.
- Representing Geisinger Health in selling the USD 7 billion health provider, insurer and medical school, to Kaiser Foundation Hospitals and its new platform company, Risant Health.
Dentons
Known for its work on insurance fraud issues and regulatory compliance matters, Dentons offers the full spectrum of contentious, transactional, and strategic services required by a variety of stakeholders in the health insurance space, boasting a particular specialism in Long Term Care insurance disputes, and a strong track record advising managed care organizations. The team is jointly led by Kimberly Kerry, who is based across San Francisco and Oakland, and NYC-based Janice Ziegler, who has spent a career building expertise in Medicare and managed care matters more broadly, an area where Charles Luband is also key. In DC are veteran Bruce Merlin Fried, a key contact for health plans and physicians’ organizations, and Christopher Janney, who is well-versed in orchestrating complex business and clinical arrangements. In the New York office, Claire Bornstein is a go-to for all things Medicaid, and Sean Cenawood‘s area of expertise is fraud investigations and litigation. Also integral to the group is DC-based fraud and abuse and regulatory compliance specialist Gadi Weinreich. Associate Margo Wilkinson Smith handles a diverse set of matters in Kansas City. Kate Sullivan Morgan joined in December 2024, bringing expertise in the Affordable Care Act and private insurance contracts to the team.
Responsables de la pratique:
Kimberly Kerry; Janice Ziegler
Autres avocats clés:
Charles Luband; Bruce Merlin Fried; Christopher Janney; Claire Bornstein; Sean Cenawood; Gadi Weinreich; Kate Sullivan Morgan; Margo Wilkinson Smith
Principaux dossiers
- Representing a global and US manufacturer of technologically advanced eyeglass lenses in a qui tam False Claims Act litigation filed in the US District Court for the Central District of California. Relators also claim violation of, and treble damages and civil fines under, the Illinois Insurance Claims Fraud Prevention Act.
- Providing UCare with federal government relations and health care regulatory counsel.
Greenberg Traurig LLP
The healthcare and FDA practice at Greenberg Traurig LLP houses a team adept at advising various stakeholders from health plans to insurance carriers on the full spectrum of health insurance matters. Co-chairing the practice from Albany, Tricia Asaro represents payors in a range of matters. David Peck co-leads from the Fort Lauderdale office. Well-versed in a range of services, the team is notably experienced in regulatory and compliance counsel, large-scale transactional work, government investigations, and healthcare entity bankruptcies and wind-downs. Albany-based Eileen Hayes focuses on Medicaid, managed care, and insurance regulatory matters, and DC-based Nancy Taylor‘s diverse practice spans FDA regulation and approvals, and transactions, informed by her experiences working government-side and as an industry executive. Back in Albany, Harold Iselin focuses on the intersection between governmental affairs and health insurance.
Responsables de la pratique:
Tricia Asaro; David Peck
Autres avocats clés:
Eileen Hayes; Nancy Taylor; Harold Iselin; Elizabeth Sacco
Principaux clients
Aetna
MVP Health Plan
United Healthcare
Fidelis Care
Bright Health
NY Health Plan Association
Independent Health
MetroPlus
The Hartford
The Standard
ShelterPoint
Chubb
New York Life
Oscar Health
Emblem Health
Lincoln Financial Group
Principaux dossiers
Hogan Lovells US LLP
With particular strength in Florida, the Hogan Lovells US LLP health insurance practice is broad and flexible, handling matters at the intersection of health insurance and technology, with experience in issues relating to AI integration. Under the direction of DC-based Ronald Wisor, the group navigates key areas of interest for insurers, including antitrust and market consolidation advisory work, reimbursement models such as Medicare and Medicaid, private insurance coverage disputes, fraud, abuse, and government investigations, federal and state compliance counsel, and privacy and data protection matters within the health insurance sector. In Miami, board-certified health lawyer Craig Smith comes highly recommended for a wide array of transactional and regulatory matters, notably assisting healthcare providers, managed care organizations, and private investors on Medicaid and Medicare matters. LA-based Michael Maddigan focuses on litigation, and NY-based Jeffrey Schneider offers comprehensive transactional and regulatory guidance to a broad spectrum of health insurance industry stakeholders. In the DC office, Kenneth Field specializes in antitrust work, and Scott Loughlin is a key name for cyber and data issues in healthcare.
Responsables de la pratique:
Ronald Wisor
Autres avocats clés:
Craig Smith; Michael Maddigan; Kenneth Field; Scott Loughlin
Principaux clients
UnitedHealth Group
Optum
Globe Life, Inc.
Kaiser Permanente
Parker Jewish/AgeWell New York, LLC
Molina Healthcare of Florida
UnitedHealthcare of Florida
CIGNA Healthcare
Blue Cross and Blue Shield (BCBS) companies
Principaux dossiers
- Represented UnitedHealthcare in various lawsuits across the country, including Florida and California.
- Advised Kaiser Permanente on the creation of Risant Health, a new subsidiary to which Kaiser expects to commit $35-50 billion in the next five years, aimed at acquiring health systems in various parts of the United States.
- 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.
O'Melveny
O'Melveny remains a go-to for a wide array of high-stakes contentious health insurance-related instructions. Co-chair David Deaton, whose vast experience spans anti-kickback claims, acting for clients in state and federal inquiries, managed care issues and Medicare and Medicaid reimbursement issues, is based in Newport Beach, and fellow co-chair Lee Blalack, based in Washington DC, is a seasoned trial lawyer who has represented some of the firm’s biggest clients in a variety of disputes. San Francisco-based Caitlin Bair is well-versed in FCA and anti-kickback matters, internal investigations, enforcement inquiries, and compliance and regulatory advice. In LA, litigator Stephen Sullivan acts for prominent healthcare players in regulatory, and enforcement matters. Back in the DC office, Kevin Feder focuses on defending insurers in class actions and lawsuits brought by hospitals and healthcare providers, and Benjamin Singer represents healthcare sector clients in criminal and civil investigations by state and federal agencies.
Responsables de la pratique:
David Deaton; Lee Blalack
Autres avocats clés:
Caitlin Bair; Stephen Sullivan; Kevin Feder; Benjamin Singer; Elizabeth Bock; Jim Bowman
Les références
‘The team is experienced with all forms of managed care/health-related litigation. Strong substantive knowledge of relevant law.’
‘Kevin Feder has deep industry experience and is able to navigate and understand complicated subject matters with relative ease.’
Principaux dossiers
Reed Smith LLP
Under the direction of Chicago-based trial lawyer Martin Bishop, Reed Smith LLP‘s practice tends toward complex, high-stakes litigation, and is trusted by some of the healthcare sector’s biggest names. Bishop is joined by several litigators in the Chicago office, including government program specialist Steven Hamilton, mental and behavioral health cases-focused Rebecca Hanson, Bryan Webster, whose practice encompasses fraud, waste and abuse, billing disputes, and civil rights matters, and Alexandra Lucas, noted for her experience with the No Surprises Act. In California, Kurt Peterson deals with class actions and individual suits against insurers, Amir Shlesinger is adept at navigating ERISA and reimbursement disputes. Over in Pittsburgh, Will Sheridan leads a specialized health insurance antitrust team.
Responsables de la pratique:
Martin Bishop
Autres avocats clés:
Steven Hamilton; Rebecca Hanson; Bryan Webster; Alexandra Lucas; Kurt Peterson; Amir Shlesinger; Will Sheridan
Principaux clients
Blue Cross and Blue Shield of New Mexico
Principaux dossiers
- Representing Blue Cross Blue Shield of New Mexico (BCBSNM) in a qui tam case under the federal False Claims Act and various state statutes, concerning allegations of improperly retained overpayments under the New Mexico Medicaid managed care program.
Sheppard, Mullin, Richter & Hampton LLP
Sheppard, Mullin, Richter & Hampton LLP’s health insurance practice runs the gamut, and the team is highly experienced in advising clients on issues such as Medicare Advantage, Medicare Part D, regulatory and compliance concerns, as well as in acting for clients in complex litigation at trial and appellate level. Many major insurance carriers, MCOs, health plans, providers, and other key stakeholders in the health care market count themselves as clients of the firm, benefiting from the group’s extensive resources. The expanding practice is directed by a team of four: Century City-based Eric Klein, who is well-versed in M&A and the design of payor and provider initiatives and compliance programs, San-Francisco-based Eric Newsom, who is similarly instrumental in mergers and acquisitions, affiliations, corporate reorganizations, joint ventures, PE investments and disposition transactions, DC partner Christine Clements, who leverages extensive in-house experience and is noted for her Medicare Advantage chops, and NYC-based Amanda Zablocki, who advises health insurance players on ventures, corporate governance, fraud, waste and abuse, as well as Medicare and Medicaid reimbursement. Also central to the practice are Lynsey Mitchel, an HMO regulatory specialist hailing from Century City, and Los Angeles litigator Moe Keshavarzi. Century City-based Matthew Goldman concentrates on regulatory and transactional work.
Responsables de la pratique:
Eric Klein; Christine Clements; Eric Newsom; Amanda Zablocki
Autres avocats clés:
Lynsey Mitchel; Moe Keshavarzi; Matthew Goldman
Les références
SCAN Health Plan
Blue Shield of California
Molina Healthcare
Principaux dossiers
- Helped SCAN Health Plan secure a major victory that will allow it to recoup more than $250 million in Medicare Advantage payments, after challenging CMS’s revised calculation of “STAR Ratings” for 2024.
- Guided Molina Healthcare, Inc. through the healthcare regulatory aspects of Molina’s acquisition of Brand New Day and Central Health Plan of California, both wholly owned subsidiaries of Bright Health Company of California, Inc.
Crowell & Moring LLP
The healthcare practice at Crowell & Moring LLP is a group is well-versed in addressing diverse legal needs in the health insurance space, such as transactions and M&A, and complex arbitration and litigation, such as ERISA lawsuits and coverage disputes. Alongside contentious and transactional work, the team advises insurers and health plans of various sizes on compliance and regulatory matters. Practice co-head Troy Barsky, who specializes in Medicaid and Medicare matters and fraud and abuse disputes, is joined by co-lead and seasoned litigator Christopher Flynn, who oversee matters from Washington DC. Other foundational team members include Jennifer Romano, who takes on high-stakes disputes from the LA office, DC-based Mike Lieberman, who litigates commercial health care disputes at the federal and state level, and other DC litigator Kelly Hibbert.
Responsables de la pratique:
Troy Barsky; Christopher Flynn
Autres avocats clés:
Jennifer Romano; Mike Lieberman; Kelly Hibbert
Les références
‘Strong industry experience, diverse teams, efficient staffing, great client service, and excellent work product.’
‘Jennifer Romano has deep industry experience and is a strong tactician, and Christopher Flynn has deep industry experience and excellent trial skills.’
Principaux clients
Alignment Healthcare
Central California Alliance for Health
Health Net Federal Services LLC
L.A. Care Health Plan
Principaux dossiers
- Acted as lead counsel for Health Care Services Corporation (HCSC) in its effort to recover over $100 million from Walgreen Co. (Walgreens) resulting from Walgreen’s fraudulent conduct.
- Obtained a victory for UnitedHealthcare against Samaritan Health System worth $5 million following an expedited four-day AAA arbitration hearing last summer in Oregon.
- Defending Kaiser Foundation Health Plan, Inc. in a series of class-action lawsuits filed against Kaiser, MultiPlan, and several other large payors, alleging a conspiracy between MultiPlan and its clients to use MultiPlan’s “repricing” software to artificially depress reimbursement rates paid to out-of-network health care providers.
Epstein Becker & Green, P.C.
Epstein Becker & Green, P.C. is well-established in healthcare law, and is experienced in advising health plans, managed care organizations, and other healthcare stakeholders on a variety of contentious and non-contentious matters, including those related to Medicare and Medicaid programs, pharmacy benefit managers, and regulatory matters such as the Affordable Care Act. The practice is headed by Mark Lutes and George Breen in DC, and Amy Dow who takes the lead in the Chicago office. Other key partners include DC-based Alan Arville, whose practice encompasses pharmacy matters, and regulation and government investigations specialist Raja Sékaran. Andrew Rusczek is well-versed in fraud and abuse, and Lisa Pierce Reisz is regularly engaged for her data protection and privacy expertise.
Responsables de la pratique:
Mark Lutes; George Breen; Amy Dow
Autres avocats clés:
Alan Arville; Raja Sékaran; Andrew Rusczek; Lisa Pierce Reisz; Steven Epstein
Les références
‘The legal team has a unique understanding of operations and legal processes of contracting with providers, provider networks, administrative services agreements, plan-to-plan agreements for our case.’
‘Raja is always available to assist in urgent situations and is consistent in his communications. He is also experienced in the development of local health authority health plans.’
Principaux dossiers
Gibson, Dunn & Crutcher LLP
Led by seasoned coverage litigators Deborah Stein and Geoffrey Sigler, Gibson, Dunn & Crutcher LLP is best known for its health insurance litigation aptitude, regularly handling class actions, coverage litigation, antitrust disputes, and various other lawsuits brought against insurance carriers, with notable success in recent years acting for United Healthcare and its subsidiaries in various high-stakes disputes. LA-based litigator Heather Richardson is integral to the practice and is a key contact for insurer clients facing complex disputes. Other key names are San Francisco-based litigator Winston Chan, who focuses on investigations and False Claims Act defense, and Richard Doren, a veteran trial and appellate litigator who aids clients in Los Angeles.
Responsables de la pratique:
Deborah Stein; Geoffrey Sigler
Autres avocats clés:
Heather Richardson; Winston Chan; Richard Doren
Principaux clients
AIU Insurance Company
Gold Coast Health Plan
National Union Fire Insurance Company of Pittsburgh, PA
PacifiCare Life and Health Insurance Company
Presbyterian Health Plan
State Farm Life Insurance Company
United Health Group
Principaux dossiers
Groom Law Group, Chartered
With specialisms in employee benefits and government regulatory compliance, Groom Law Group, Chartered‘s sizable team is well-versed in assisting insurers, health plans, employers, and other stakeholders in the healthcare space in and out of the courtroom, regularly litigating disputes, advising clients on complex compliance issues, and preparing them for investigations by government agencies. Under the leadership of DC-based Affordable Care Act specialist and former government regulator Lisa Campbell, and Seth Perretta, whose practice centers around ERISA and federal tax matters, the group also uses its regulatory expertise to assist private equity firms investing in the healthcare sector. Supporting the team heads in DC is Xavier Baker, a key contact for managed care organizations, insurance issuers, plan sponsors, and pharmacy benefit managers, and is experienced in dealing with federal programs such as Medicare Advantage and Medicaid Managed Care. Also in DC is Jon Breyfogle, who focuses on regulatory matters and pharmacy benefit managers, Christy Tinnes, who supports employers designing health plans and insurers creating new products, and Malcolm Slee, who advises a broad array of clients on employee benefits matters, and is particularly experienced in health insurance provision for ‘gig economy’ workers. Kathryn Bjornstad Amin counsels all types of clients on a wide range of benefits, coverage, and compliance issues. Ryan Temme focuses on federal and state compliance issues.
Responsables de la pratique:
Lisa Campbell; Seth Perretta
Autres avocats clés:
Xavier Baker; Jon Breyfogle; Christy Tinnes; Malcolm Slee; Kathryn Bjornstad Amin; Ryan Temme
Principaux dossiers
Latham & Watkins LLP
The interdisciplinary team at Latham & Watkins LLP flexes its muscles across regulatory, transactional, and contentious healthcare law matters, notably representing some of the country’s most prominent health insurance carriers in high-stakes litigation. The group is led by a DC trio of John Manthei, Ben Haas, and Jason Caron, and Chicago-based partner Terra Reynolds. The department has experience handling M&A and large-scale transactions in the healthcare space, managing lawsuits regarding Medicare Advantage regulation, and supporting clients facing government agency investigations and disputes, in addition to a range of other matters. Former General Counsel of the United States Department of Health and Human Services Daniel Meron contributes deep regulatory and investigatory expertise to the practice, and David Tolley assists insurers facing government investigations as well as representing them in court.
Responsables de la pratique:
John Manthei; Ben Haas; Jason Caron; Terra Reynolds
Autres avocats clés:
Daniel Meron; David Tolley
Principaux clients
Cigna Healthcare
Humana
SCAN Health Plan
Independent Health Association
Molina Healthcare
UnitedHealthcare
Principaux dossiers
- Obtained a summary judgement fom the United States District Court for the District of Columbia for SCAN Health Plan in an Administrative Procedure Act lawsuit that will result in an award of over $250 million in federal funding to SCAN.
- Represented Molina Healthcare in its pricing of US$750 million aggregate principal amount of its 6.250% senior notes due 2033 to be sold in a private offering.
- Representing UnitedHealth in a False Claims Act litigation concerning its Medicare Advantage plans.