Matters

  • Represented a national provider in an Administrative Procedure Act challenge to federal regulations governing the independent dispute resolution process under the No Surprises Act and secured a nationwide vacatur.
  • Represented a large children’s hospital system in an Administrative Procedure Act challenge to regulations establishing reimbursement rates for outpatient services under the TRICARE program.
  • Represented a large hospital system in multiple Colorado surprise-billing arbitrations against a national HMO and secured favorable awards.
  • Represented a large hospital system in a dispute with a commercial insurer involving the underpayment of thousands of out-of-network emergency claims.
  • Represented a group of hospitals in arbitration against a national commercial payor over reimbursement for out-of-network emergency services.
  • Represented physician staffing companies in disputes with commercial payors over reimbursement for evaluation and management services, including systemic downcoding and nonpayment challenges tied to billed E/M levels.
  • Represented a national hospital system in disputes with commercial payors across the country over medical necessity and procedural denials involving complex clinical, reimbursement, and utilization-review issues.
  • Advised national hospital systems and physician groups on compliance with state and federal balance billing laws.
  • Represented a national air ambulance company in multiple putative federal class actions involving charges for emergency air ambulance services.
  • Represented medical device companies nationwide in challenges to payor medical coverage policies.