Peter Roan
Partner
Overview
Health care plans and organizations threatened by daunting litigation and regulatory challenges rely on Peter Roan to find creative solutions and achieve victories. His clients include managed care organizations at the forefront of the industry, and over three decades Peter has accumulated a particularly deep understanding of managed care businesses and the challenging regulatory environments they face.
Career & Education
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- University of Iowa, B.B.A., 1982
- Marquette University Law School, J.D., 1985
- California
Challenging and sometimes overlapping state and federal regulatory requirements conceal litigation traps for the unwary. Our health care regulatory prowess allows us to avoid the traps and exploit opportunities for our clients.
Representative Matters
- Defeated arbitration claims by a durable medical equipment supplier against a Medicaid managed care plan and obtained judgment for damages and attorney’s fees on the plan’s counterclaim based on the supplier’s fraud.
- Secured judgment for a Medicare Advantage plan of a bad faith lawsuit brought by a plan member because the member had not exhausted administrative remedies and because the claims were preempted by the Medicare Act.
- Obtained reinstatement of a specialty pharmacy following an appeal of the pharmacy’s disenrollment by the state Medicaid agency.
- Won additional reimbursement for a Medicaid managed care plan dispute with a state Medicaid agency concerning the actuarial soundness of capitation payments made by the agency.
- Represented a health plan in an arbitration by a group of hospitals alleging the plan systemically underpaid thousands of hospital claims worth tens of millions of dollars and established through sampling and audit work that the claims were grossly overstated, resulting in a favorable settlement.