– Clark Hill attorney Joseph Friedman, Member and Leader of the Firm’s Managed Care Litigation Practice, participated in the American Health Lawyers Association (AHLA) Institute for Health Plan Counsel on April 9, 2014 in Nashville, Tennessee.
Friedman, along with Elysia Solomon, Legal Counsel at Humana Inc., spoke on “Preparing for an Uptick in Litigation in Light of Healthcare Reform Implementation.” Topics included:
Preparing your legal team for inevitable anticipated Affordable Care Act (ACA) implementation litigation
Has absence of express private right of action under ACA operated to reduce anticipated litigation?
ERISA and Mental Health Parity appear to be the principal claims mechanism for civil enforcement of ACA
ACA-related litigation via the False Claims Act (FCA) likely to be a developing area of litigation, due to ACA’s modification and expansion of the FCA in general and federal subsidies involved in ACA-related programs
Despite initial fear of medical loss ratios (MLRs) providing a fertile ground for litigation challenges, preliminary reports show general compliance with MLR requirements, and little MLR-related litigation
Although the rollout of online exchanges was inelegant and frustrating, litigation over exchange access has not yet erupted