Reardon Scanlon Vodola Barnes’s attorneys have substantial experience handling health and long-term disability disputes under ERISA, billing and reimbursement disputes between payors and providers, health insurance and provider audits, and various other litigation matters involving health insurers, managing general underwriters, pharmacy benefit managers, long-term care providers and third-party administrators.
We have successfully handled the following health insurance matters:
- Defended health insurer in billing dispute with provider over improper out-of-network billing practices.
- Represented health insurer in payment dispute with MGU and reinsurer arising out of capitation arrangement.
- Defended health insurer in billing dispute with hospital over reimbursements.
- Defended health insurer in numerous disputes with various hospitals over assignment of contractual billing rights and rates where hospital attempted to impose charge master pricing.
- Successfully defended health insurer in breach of contract dispute with pharmacy benefit manager.
- Represented long-term care insurer in breach of contract and misrepresentation dispute with general agent.
- Represented workers’ compensation carrier in health care containment action involving claims of fraudulent marketing against pharmaceutical company.
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