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Health Insurance

The healthcare industry has been experiencing enormous upheaval for several years. With the passing of the Affordable Care Act, and its uncertain future, the healthcare system had been under extreme pressure to change, with the ripple effect foisting untold duress upon health insurers, plan administrators, employers and providers. Our group has the experience to help clients navigate through this healthcare minefield. Recent changes in the law, as well as decisions by State and Federal courts, are shifting the way healthcare is being delivered and paid for, which exposes payers to liability, while eroding existing protections.

We have extensive experience representing and counseling in various areas of healthcare law, including:

  • Establishment of new healthcare networks
  • Out-of-network coverage disputes
  • Healthcare network contractual disputes
  • Provider litigation
  • Benefit entitlement
  • Compliance Issues under ERISA, PPACA, fraud and abuse laws and pertinent regulations
  • Healthcare antitrust claims
  • Fraud
  • Medicare and Medicaid fraud and abuse
  • RICO
  • HIPAA analysis and implementation
  • Coverage issues
  • Counseling third-party administrators
  • Bad faith
  • Breach of fiduciary duty
  • Plan interpretation

Representative Matters

  • Obtained a published opinion from the New Jersey Appellate Division granting a protective order in a matter wherein several hospitals were seeking intrusive discovery concerning the creation and implementation of a health plan. (Capital Health System Inc., v. Horizon Healthcare Services Inc., NJ App. Div. A-2913-15 (June 23, 2016))
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