David King is a shareholder in the Health Care Litigation and Disputes practice in Nashville. Leveraging over 30 years of health care litigation experience, David’s well-seasoned approach is pragmatic and highly detailed, enabling clients to advance their business and legal interests in managed care disputes, managed care strategy and contracting and national and state legislative matters. He works with a wide range of health care entities, including profit and not-for-profit hospital systems, ambulatory surgery centers, air ambulance services, specialty providers, physician groups and ancillary service providers, as well as medical device companies.
David’s representative work includes:
Managed Care Disputes
David counsels clients on a variety of managed care matters including disputes related to underpayments, medical necessity denials, attempted recoupments and offsets, contract interpretation, refusal to contract, discrimination and retaliation against out-of-network providers and related reimbursement disputes, and related legal issues involving the Affordable Care Act, ERISA preemption, UCR laws, prompt pay laws, any willing provider laws and laws regarding payor audits, recoupments and offsets. David has years of experience and success implementing all forms of resolution for these disputes, including negotiation, mediation, arbitration and litigation.
Managed Care Strategy and Contracting
David consults with health care providers on in-network and out-of-network strategies and other issues involving the relationships among providers, insurers, self-funded plans, benefit administrators and vendors. He counsels providers on challenges such as payor coverage and reimbursement policies, reference-based pricing initiatives, surprise medical billing, ERISA and ACA laws, hospital lien laws and persuading payors to cover medical devices and procedures. He also assists providers with various managed care contracting issues, including drafting and negotiating contracts, and advising on navigating tiered and narrow networks, silent PPOs, lease/rental networks, operational challenges and revenue cycle management.
National and State Legislation
David consults with various providers on proposed national and state legislation impacting their strategies and reimbursement, such as proposed laws seeking to address “surprise” billing by hospital-based out-of-network providers and proposed laws seeking to establish rates and or dispute resolution procedures for all out-of-network emergency providers. David also strategizes about draft legislation to address improper payor practices.
David thrives on enabling clients to navigate the ever-changing and regulated health care industry. To this end, he is a frequent lecturer on payor relationships and has been nationally recognized for many years by Best Lawyers in America®, Super Lawyers and a multitude of other publications.