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Managed Care Class Actions

Overview

Crowell & Moring has extensive experience defending clients in a broad range of class action litigation in the health care and managed care industries. Joining the skills and legal acumen of lawyers in our top-ranked Antitrust and Health Care groups, we represent clients in class action lawsuits in federal and state courts across the United States, including all levels of the appellate process.

In the rapidly changing area of managed care, we understand that class actions are often used as a tool to force new and additional regulation of health-related services and products. We also understand that class action litigation has a significant public relations component, and are experienced in coordinating strategies involving the media, consumer groups, and investors. We help clients understand the legal and business implications of this type of litigation and craft appropriate resolutions that help achieve their goals.

Our litigators have successfully defended clients in the nation's largest class actions against health care plans. Among recent matters, in In re Managed Care multidistrict litigation (MDL) class actions, we obtained victories for health insurance companies in nationwide class actions alleging Racketeer Influenced and Corrupt Organizations (RICO) Act violations resulting from payment practices. In the U.S. Court of Appeals for the Third Circuit, we established a precedent under the All Writs Act that allows dueling nationwide and statewide class actions to proceed on parallel tracks.

We represented DuPont Pharma (now Bristol Myers Squibb) in the Coumadin antitrust litigation and negotiated favorable settlement of a class action litigation alleging monopolization of the warfarin drug market with Coumadin. We also represent a national managed behavioral health care organization in putative class action lawsuits in federal and state courts alleging denial of insurance benefits for the treatment of eating disorders, defended a client against class action claims by provider groups challenging alleged discrimination in health plan contracting and payment terms, and have successfully represented clients in subrogation class actions.

Insights

Client Alert | 8 min read | 01.18.23

CMS Issues “In Lieu of” Services Guidance to Address Health-Related Social Needs in Medicaid Managed Care

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care. This option is designed to help states offer alternative benefits that take aim at a range of unmet HRSNs, such as housing instability and food insecurity, and to help enrollees maintain their coverage and improve health outcomes. ...

Insights

Client Alert | 8 min read | 01.18.23

CMS Issues “In Lieu of” Services Guidance to Address Health-Related Social Needs in Medicaid Managed Care

On January 4, in its most recent effort to expand federal support for addressing health-related social needs (HRSNs), the Centers for Medicare & Medicaid Services (CMS) issued guidance to clarify an existing option for states to address HRSNs through the use of “in lieu of” services and settings policies in Medicaid managed care. This option is designed to help states offer alternative benefits that take aim at a range of unmet HRSNs, such as housing instability and food insecurity, and to help enrollees maintain their coverage and improve health outcomes. ...