Insurers & Managed Care Organizations

Attorneys in Sonnenschein’s Health Care Practice Group have substantial experience counseling health insurers and managed care organizations (MCOs) in connection with a wide range of legal issues.  For example:

• The Firm has extensive experience in (1) the formation and licensing of health insurers, MCOs, and third party administrators (including state licensure compliance), (2) advising clients regarding mergers, acquisitions, sales and reorganizations of indemnity insurers, HMOs, PPOs, IPAs and PHOs, and (3) providing strategic advice concerning the acquisition or transfer of assets of troubled health plans.
• On behalf of health insurers and MCOs across the country, Sonnenschein provides a broad range of counseling and advice with respect to regulatory matters, including fraud and abuse, health information privacy and security, ratemaking, ERISA preemption, coverage and policy language, any willing provider rules, and Medicare Secondary Payer issues.
• The Firm has considerable experience representing health insurers and MCOs in connection with litigation, administrative proceedings, and civil and criminal audits and investigations.  For example, the Firm has represented health plans in actions alleging improper coding, violation of the Medicare Secondary Payer law, and violations of Federal and State privacy laws and regulations.