The Future of Provider vs. Payor Disputes
Elizabeth Monohan
Assistant General Counsel
Humana Inc
Tony Rodriguez
Senior Counsel
Kaiser Foundation Health Plan
Kevin Feder
Counsel
O'Melveny & Myers LLP
Jeffrey S. Gleason
Partner
Robins Kaplan
Geoffrey M. Sigler
Partner
Gibson, Dunn & Crutcher LLP
- Lawsuits with out-of-network providers and the confusion over contracts
- Disputes between MCOs and third party payors
- Hospital suits against MCOs
- Handling suits from hospitals who believe they were underpaid
- Fights over emergency room payments
- Handling improper overnight stays and other types of overbilling
- Emerging trend of health plans being the plaintiff rather than the defendant