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Payer Litigation: What Do We Do Now?

PDF California Society of Healthcare Attorneys' 2014 Fall Seminar
Los Angeles, CA
November 7, 2014

Andrew Selesnick and Stacey Zill, along with Kenneth Smersfelt, Partner at Reed Smith, spoke at the California Society for Healthcare Attorneys’ (CSHA) 2014 Fall Seminar on “Payer Litigation: What do we do now?” Their presentation was held on November 7, 2014 at 10:45 am PST. 

The payer-provider community has been grappling with recent appellate court rulings that are impacting how they conduct business. During this session, three-expert panelists provided an overview of current developments affecting reimbursement, overpayments, and measures of recovery.  They also offered best practices on how to effectively navigate through the thorny process of payer disputes and litigation.

Topics covered included:

  • An overview of the Children’s Hospital Central California v. Anthem Blue Cross, Centinela-Freeman Emergency Medical Associates v. Health Net, et al.,  and other significant cases affecting provider-payer litigation;
  • Analysis of reasonable value;
  • Measures of Recovery;
  • Effective Strategies to Mitigate Risks for Disputes and Litigation;
  • How to Develop a Practical Disputes and Litigation Plan;
  • And More!

At the conclusion of this session, attendees:

  1. Understood how to value provider services in the marketplace;
  2. Learned how to approach provider-payer litigation and how to develop a winning strategy;
  3. Received tips on payer litigation; and
  4. Recognized the potential pitfalls in the process and how to avoid them.

The CSHA Fall Seminar offered several hours of MCLE credit and featured educational presentations designed to provide you with current and relevant information regarding health care law.

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