Managed Care and Pharmaceutical Dispute Resolution

Over the past 15 years, McClellan Bernstiel has amassed substantial expertise in a variety of health benefit and pharmaceutical disputes focused primarily on reimbursement for health care services and supplies. Based on our experience in resolving complex reimbursement and benefit disputes, we work with all departments within managed care organizations and pharmaceuticals to develop practical legal solutions and strategies for unique situations. We routinely defend managed care organizations and pharmaceuticals with meticulous planning against causes of action in the following areas:

  • Class Actions
  • Serial Litigation
  • ERISA Violations
  • HIPAA and HITECH Violations
  • Medical Necessity Lawsuits
  • Prompt Pay Laws

In addition, we assist managed care organizations in identifying and combating a variety of insurance frauds as well as developing and monitoring strategies for compliance with state and federal regulations . McClellan Bernstiel 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.