In the highly complex and evolving business of managed care, Bradley’s clients depend on our experienced healthcare litigators to aggressively protect their interests. Our lawyers thoroughly understand the intricate contract and legal issues particular to managed care, and our litigation team has significant experience in representing for-profit and not-for-profit providers, as well as health plans and other managed care organizations.

Broad-scope Managed Care Litigation Practice

Whatever disputes our clients face, they can count on the Bradley team to skillfully and strategically advocate for their positions in negotiations, alternative dispute resolution proceedings (ADR), and court. In our managed care litigation practice, we combine our vast healthcare law knowledge with our extensive trial experience to effectively represent clients in matters involving:

  • Out-of-network payment disputes, including usual and customary rates
  • Fraud and abuse
  • Affordable Care Act (ACA)
  • Class actions
  • Employee Retirement Income Security Act (ERISA)
  • Mental health parity
  • Treatment for eating disorders and addiction
  • Health Insurance Portability and Accountability Act (HIPAA)
  • Participating provider arrangements
  • Insurance coverage litigation
  • Medicaid and Medicare reimbursement issues
  • Medicare Secondary Payor Act
  • Medicare Advantage Programs
  • Specialty health plans and discount programs
  • State laws governing health maintenance organizations (HMOs) and preferred provider organization (PPOs)
  • Utilization review
  • Workers’ compensation and other benefit coverage disputes

In managed care litigation, achieving a positive outcome requires the ability to understand and apply intricate — and often highly complex — federal and state healthcare laws and regulations to increasingly complicated fact patterns. At Bradley, we are at the forefront of the legal issues affecting the managed care industry, and we draw upon insights gained from our full-service healthcare law practice to offer practical, efficient, and trial-tested solutions.

We have a long list of healthcare clients that includes:

  • Hospitals
  • Physician practices
  • Nursing homes
  • Provider networks
  • Emergency service providers
  • Home health providers
  • Imaging centers

Bradley attorneys also represent health plans (HMOs and PPOs), health insurers, third-party administrators, and other managed care organizations in benefit disputes and litigation involving participating versus non-participating provider status. Disputes with in-network and out-of-network providers each present unique issues, and achieving favorable outcomes in litigation requires the ability to address these issues effectively within the relevant context.

Regardless of your role in the managed care industry and the specific challenges you are facing, Bradley’s healthcare litigation team has the knowledge, experience, and resources to protect you. When a dispute threatens to disrupt your business or practice, you can trust Bradley to meet your needs.