MANAGED CARE LITIGATION, DISPUTE RESOLUTION, REGULATORY COMPLIANCE

As legal controversy and debate continue to dominate reimbursement for health care services throughout the nation, it is necessary to have a practiced hand not only to advise and protect managed care organizations, but to advocate their interests as well. Our firm offers experience upon which practical legal solutions and strategies are developed for unique situations. Given the perception that managed care organizations have deep pockets, we defend managed care organization providing with meticulous planning against causes of action in the following areas:

  • class actions;
  • serial litigation;
  • ERISA violations;
  • HIPAA and HITECH violations;
  • medical loss ratios;
  • medical necessity lawsuits; and
  • prompt pay laws.

In addition, we have a robust practice assisting managed care organizations in combatting insurance fraud committed by the provider community. We thrive in the complex regulatory and statutory environments to which managed care organizations are subject, and permit managed care organizations to take comfort in our expertise, knowing that their compliance with extant regulations and statutes is addressed properly and further are poised to respond appropriately to regulatory and statutory developments.

Whether the situation calls for addressing an alleged regulatory violation, resolving a dispute, managing a crisis, or defending against a lawsuit, Stewart Bernstiel Rebar & Smith has the expertise upon which managed care organizations rely. The firm has counseled managed care organizations that are preparing for lawsuits arising from the impending changes in the Patient Protection and Affordable Care Act as well as reconciling potential conflicts between the emerging federal mandates and state laws and regulations. In addition, the firm counsels managed care organizations to implement safeguards against insurance fraud and abuse.