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NY HOOPS: What’s Coming Down the Pike – A Look at Policy, Regulatory, Managed Care and Reimbursement Issues Impacting Health Care in 2019 and Beyond

Event | 02.25.19, 9:00 AM EST - 1:30 PM EST

Address

The Yale Club of New York City
50 Vanderbilt Avenue, New York, NY 10017

With the expansion of Crowell & Moring’s Health Care practice in New York City, we are pleased to invite you to our first Healthcare Ounce of Prevention Seminar (HOOPS) event in New York, featuring two panels on relevant issues facing the health care industry.


The first panel will include Washington, D.C. firm lawyers and advisors who have extensive experience working in high-level roles within the government and with health care clients on government-facing issues. With the recent mid-term elections, fast-paced legislative and regulatory changes are taking place with significant impact to clients both in and touching the health care industry.


The second session will be a panel discussion covering evolving government oversight, guidance, and enforcement of Medicare Advantage and Medicaid managed care plans including medical loss ratio audits, value-based payment arrangements, risk adjustment, strategies for managing potential False Claims Act exposure, compliance risks, and innovative business practices.


Both presentations will provide ample opportunities for Q&A and will be followed with a networking reception.


To learn more about our recent New York Health Care team expansion, please visit our website.


Agenda
2:00 pm – Welcome and Opening Remarks
2:15 pm – Political Update from Washington D.C. Insiders
3:15 pm – Break
3:30 pm – A Look at Key Issues Impacting Medicare Advantage and Medicaid managed care
4:30 pm – Questions and Closing Remarks
5:00 pm – Reception


If you have health care clients who would be interested in attending this, please contact Heather Quinn-Simez.

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.