Managed Care Litigation: Anti-Assignment Clauses, Reimbursement Claims, State Law Claims

This CLE webinar will guide healthcare counsel on the recent developments in managed care litigation. The panel will address anti-assignment clauses; claims related to reimbursement; and more. The panel will discuss strategic and practical considerations involved in litigating managed care matters.

To minimize the risk of litigation from healthcare providers many health plan sponsors include anti-assignment provisions in the insurance contracts. These provisions prohibit or substantially limit plan participants from being able to assign their rights under the plan. The Ninth Circuit Court of Appeals held that plans waive these provisions when they act inconsistently with them. Beverly Oaks Physicians Surgical Ctr., LLC v. Blue Cross & Blue Shield of Ill. (9th Cir. 2020). The Third Circuit Court of Appeals noted that providers can bypass anti-assignment clauses if they hold valid powers of attorney. American Orthopedic & Sports Med. v. Ind. Blue Cross Blue Shield (3d Cir. 2018). These developments have shifted how litigators approach anti-assignment issues.

Managed care disputes also address a variety of other issues, including state law reimbursement claims by out-of-network providers; ERISA preemption; recoupments and offsets; the No Surprises Act; and other hot topics.

Listen as our authoritative panel of healthcare attorneys examines recent developments in managed care litigation. The panel will discuss anti-assignment clauses; claims related to reimbursement; full and fair review of ERISA claims; and state law claims. The panel will discuss strategic and practical considerations involved in litigating managed care matters.