Health Care Business Litigation
DAE’s health care clients include medical institutions, providers and insurers. They all face tremendous business and legal pressure—and lawsuits. To help, we apply our trial readiness with a deep understanding of California’s statutes and the obligations health care companies must meet.
Health Care Business Litigation
Our counsel factors in clients’ daily operations, profitability and viability, and we have extensive experience litigating, trying and resolving disputes related to:
- Billing and Medicare fraud
- False Claims Act and Qui tam
- Reasonable value of medical services
- Employment
- Breach of contract
- Trade secrets and noncompete agreements
- Partnership dissolutions
We have established new health care law and offer in-depth experience with the California Department of Managed Health Care.
Health Care Litigation Representative Matters
Working in state and federal courts and settlement forums throughout California, DAE health care lawyers act early to minimize escalation. We also provide extensive guidance on following compliant employment practices. When demands are steep or a conflict becomes intractable, we aim to add business value to the resolutions we achieve, as the matters below illustrate.
FEES, FRAUD AND FALSE CLAIMS ACT
Obtained a full defense decision in a bench trial on behalf of a medical group in a dispute over reasonable value of medical services. California Court of Appeal subsequently affirmed the ruling in a published decision.
Negotiated a highly favorably settlement for a health care organization against provider in coordinated proceeding involving the hotly disputed issue of what constitutes “reasonable and customary” fees for medical services. Settlement was a direct result of a successful motion to compel that required the physician to produce a wide array of billing records.
Defended health plans and insurers in dozens of out-of-network usual, customary and reasonable (UCR) professional and facilities cases.
Obtained summary judgment on behalf of a health plan in a dispute over health plan’s financial responsibility for a range of medical services, with the Ninth Circuit subsequently affirming the ruling.
Representing large HMO in lawsuit alleging that one of its providers, a dermatologists, committed massive fraud by charging millions in services that were never performed.
Secured a favorable jury verdict on behalf of health care clients sued by one of the largest ER groups in the United States seeking roughly $30 million in damages. The jury awarded a fraction of what the ER group sought in the lawsuit.
Defending health care clients in False Claim Act action that alleges defendants falsely submitted millions of dollars in claims to Medicare for hospice services.
CONTRACT AND BUSINESS DISPUTES
Defended a “bet-the-company” arbitration related to contract claims between a medical group and management company, resulting in award of all claims in client’s favor.
Obtained a TRO and a preliminary injunction on behalf of pharmaceutical company against former employee in trade secret case.
Defending health care companies in contentious unfair competition lawsuit by hospital seeking over $60 million in damages .
Represented Independent Practice Association (IPA) against provider for breach of contract and various business torts and obtained preliminary injunction prohibiting the provider from improper solicitation of IPA members. The order was affirmed on appeal.
Obtained dismissal of provider’s cross-complaint against client IPA alleging wrongful enforcement of contractual exclusivity rights under the anti-SLAPP statute. The dismissal was affirmed on appeal.
Obtained summary judgment on behalf of major pharmaceutical manufacturer facing putative class action consumer protection claims.
EMPLOYMENT
Obtained a TRO and a preliminary injunction on behalf of pharmaceutical company against former employee in trade secret case.
Secured an unprecedented injunction against a hospital that had sought to shut out physicians who worked in the hospital’s ER. About a year later, after the hospital failed to obey the injunction, convinced the court to hold an unusual, one-week criminal contempt trial and find the hospital guilty on 14 of 15 counts.
Secured dismissal of claims by two former employees of hospital for retaliation and harassment.
California Industries. Strategic Counsel.
DAE represents global leaders, innovators and market disruptors with workforces and operations in California.
From online retailers and multimedia agencies to financial and health care institutions, we operate in the industries that shape California commerce.