Health Care Litigation

Crowell & Moring represents a broad array of health care clients, including managed care plans, insurers, hospitals, physician groups, behavioral health companies, pharmaceutical companies, biotech companies, and health care trade associations. We regularly represent health industry clients in federal and state courts throughout the country as well as before regulatory agencies at both the state and federal level, in arbitrations, and other extra-judicial forums. Recognized nationwide for our health care and litigation acumen, we are frequently engaged as litigation counsel in class actions and in other cases whose impact is industrywide.

Our litigation services are broad in scope. Our health care litigators have successfully defended clients in the nation's largest class actions against health care plans, obtained injunctions against CMS, recovered hundreds of millions of dollars from the federal government on health care contracts, secured dismissal of RICO class action claims, convinced the Department of Justice to drop criminal and civil False Claims Act investigations of our clients, successfully defended clients under criminal investigation regarding HIPAA privacy compliance, and resolved litigation with state attorneys general on security breach notification allegations. From regulatory challenges and the defense of criminal charges, to commercial and False Claims Act-based civil litigation, our litigators enable clients with complex business structures in a highly regulated industry to successfully navigate their most troubling legal disputes.

The firm has successfully litigated many cutting edge issues on behalf of these clients, including the following types of disputes:

• Managed care-related litigation, including RICO class actions, breach of contract and underpayment actions, ERISA claims, subrogation class actions, utilization review
• Fraud and abuse-related litigation such as civil false claims actions (including whistleblower suits), criminal prosecutions, and administrative proceedings
• Antitrust cases, including successful defense against price fixing, boycott, monopolistic bundled pricing, and provider exclusion allegations for hospitals, insurers, HMOs, and trade associations, and federal court and state insurance department challenges to mergers
• Claims arising out of federal health care programs, including FEHBP, CHAMPUS/TRICARE, Medicare, and Medicaid
• Intellectual property and licensure issues
• Privacy claims
• False Claims Act allegations concerning establishment of pharmaceutical "average wholesale prices"
• RICO challenges to alleged fraudulent promotion of prescription medications and alleged conspiracies to deny payment to health care providers
• Grand jury investigations into compliance with HIPAA privacy obligations regarding disease management programs
• State attorney general litigation alleging non-compliance with HIPAA and state law security breach notification requirements