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Matthew M. Leighton

Associate
Associate
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Areas of Focus

Overview

Combining his experience with the legislative process, as a health care industry analyst within a law firm, and as an attorney, Matt provides clients comprehensive insight to their legal goals.

Matt is a health care associate in Crowell’s Washington D.C. office, and his practice focuses on serving payers, providers, and other health care industry clients in a broad array of legal matters spanning litigation, investigations, and regulatory compliance. He has previously worked on a diverse array of disputes in areas such as ERISA; the No Surprises Act; health care fraud, waste, and abuse; pass-through billing; payer-provider contract disputes; and affirmative recoveries by payers.

Matt has experience deconstructing complex fraud schemes that targeted payers, giving him deep insight into the inner workings of payers and various types of providers. He has a comprehensive yet practical understanding of claims adjudication and billing processes; pharmaceutical distribution and reimbursement; out-of-network provider reimbursement; durable medical equipment reimbursement; and other health care areas. This experience has left him adept at navigating the interlocking layers of statutes, regulations, and other forms of regulatory guidance, and identifying how they affect the real-world disputes that arise across the health care industry.

In addition to his extensive health care practice, Matt has had success in pro bono matters, defense of eminent domain actions, and federal appeals.

Career & Education

    • United States House of Representatives
      2010–2013
    • United States House of Representatives
      2010–2013

    • Mitchell Hamline School of Law, J.D., 2019
    • University of Minnesota Twin Cities, B.A., 2009
    • Mitchell Hamline School of Law, J.D., 2019
    • University of Minnesota Twin Cities, B.A., 2009

    • Minnesota
    • District of Columbia
    • U.S. District Court for the District of Minnesota
    • U.S. District Court for the District of North Dakota
    • Minnesota
    • District of Columbia
    • U.S. District Court for the District of Minnesota
    • U.S. District Court for the District of North Dakota

Representative Matters

  • Advised large health insurance company on the evolving judicial interpretation of challenges to the No Surprises Act and arbitration awards issued under that law.
  • Successfully represented large health insurer in defense of ERISA action brought by billing company. Helped eliminate client’s defensive risk through affirmative counterclaims alleging fraud against plaintiff and over twenty providers.
  • Represented numerous health insurers in disputes with health care providers who used tax-exempt patient assistance charities to enroll Medicaid-eligible patients in higher reimbursing health care plans available through Health Insurance Exchanges.
  • Represented numerous health insurers in disputes with pharmaceutical manufacturers who used tax-exempt patient assistance charities to fund Medicare Advantage enrollees’ out-of-pocket drug costs in ways that violated federal law and guidance from the Department of Health and Human Services’s Office of Inspector General.
  • Developed factual basis for large health insurer suit against specialty provider accused of engaging in pass-through billing.
  • Defended health insurance companies in CARES Act litigation brought by diagnostic laboratories.
  • Leveraged multiple settlements by the Department of Justice with health care providers to recover millions of dollars on behalf of Medicare Advantage organizations and Medicare prescription drug plans through pre-suit negotiations.
  • Successfully obtained preliminary injunction of an eminent domain action while representing family whose land was being condemned by a North Dakota municipality.
  • Drafted appellate brief that successfully overturned the denial of a motion to quash. Appeal was before the Third Circuit Court of Appeals and was decided without argument.

Practices