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15th Annual Advanced Forum on Managed Care Disputes and Litigation

Event | 05.02.24 - 05.03.24

Address

The Metropolitan
233 S. Wacker Drive
Chicago, IL 60606

Crowell & Moring Partners Christopher Flynn and Kelly Hightower Hibbert, members of the firm's Health Care Group, will be speaking at the 15th Annual Advanced Forum on Managed Care Disputes and Litigation, taking place from May 2nd-3rd in Chicago.

ACI’s Advanced Forum on Managed Care Disputes and Litigation offers an unparalleled learning experience, specifically designed for the MCO legal community. Attend and develop winning legal strategies and business best practices for claims management from our esteemed faculty of outside counsel, in-house lawyers, and executives.

For more information, please visit these areas: Health Care

Preparing for a Surge in Health Plan Fee Litigation

Presented by: Christopher Flynn
May 2 at 1:30 p.m. CST

Discussion Topics Include:

  • Examining litigation trends in excessive fee claim disputes target defendants
    • Review of three recent cases
    • Lessons from retirement fee litigation
    • Dissecting typical excessive fee litigation claims and common elements
  • Exploring disclosure requirements
  • Navigating service arrangements—litigation against health plan brokers and consultants
  • Anticipating excessive fee litigation: key considerations in preparation for the lawsuit before its filed

Fraud and Abuse: MCO Takeaways from Recent Investigations and Enforcement Activity in the Healthcare Industry

Presented by: Kelly Hightower Hibbert
May 3 at 9:00 a.m. CST

Discussion Topics Include:

  • Analyzing how the U.S. ex rel. Schutte v. SuperValu Inc. decision will impact the FCA defense landscape for MCOs
  • Examining the latest kickback schemes involving providers and labs and how they are impacting MCOs
    • Assessing the AKS enforcement landscape involving government programs and commercial plans
    • Implications of the circuit split on FCA based on AKS
  • Identifying trends in fraudulent billing that MCOs need to watch
    • Telehealth, genetic testing
  • Exploring lessons learned for MCOs from notable criminal and civil actions taken by the DOJ
  • Spotlight on investigations into mental health and addictions services
    • Uncovering schemes involving sober living homes

Insights

Event | 02.20.25

Has the Buss Stopped? Recoupment Today

Has the Buss Stopped? Recoupment Today: In 1997, the California Supreme Court decided Buss v. Superior Court. In Buss, the court concluded that a liability insurer that defended a mixed action could seek reimbursement from the insured for the defense costs associated with the claims that were not even potentially covered. Since then, numerous courts have held that insurers are entitled to recoup their defense costs associated with uncovered claims or causes of action. On the other hand, a significant number of courts have rejected insurers’ right to recoupment, at least in the absence of a policy provision granting the insurer that right. Some commentators have even suggested that the current judicial trend might be away from permitting insurers to recoup their defense costs. Is that correct? Has the Buss stopped? This panel of coverage experts will analyze insurers’ claimed right to recoupment today, and offer their perspectives on what the law on recoupment should perhaps be and might be in the future.