Matters

  • Led successful negotiation of a managed care arrangement between a large, multi-hospital health system and an insurer, valued at over $3 billion.
  • Represented a specialty pharmacy as it appealed its termination from an insurer’s provider network, resulting in its reinstatement.
  • Defended hospital in hearing before a Quality Improvement Organization resulting in CMS withdrawing its allegation that the hospital violated EMTALA and should be sanctioned.
  • Counseled a newly formed ACO on its structure, arrangements with providers, and value-based agreements with commercial insurers.