Health Care Litigation

We have a very active health care litigation practice. Representative matters include:

  • TennCare Litigation.
    For many years, we have successfully represented the State of Tennessee in a number of cases challenging the State’s broad-based reform of its Medicaid program. The State was a signatory to several consent decrees that arguably limited its ability to reform its medical programs. In one such case, the district court ruled that the consent decree barred implementation of changes to the eligibility requirements for the State’s Medicaid program. We convinced the Sixth Circuit to reverse two of the lower court’s orders within a span of three months. Rosen v. Goetz, 410 F.3d 919 (6th Cir. 2005); Rosen v. Goetz, 129 Fed. Appx. 167, 2005 U.S. App. LEXIS 6444 (April 12, 2005). In a second case, Grier v. Goetz, No. 79-3107 (M.D. Tenn.), we successfully convinced the district court, following a three week trial, to substantially modify a consent decree that placed onerous restrictions on the State’s ability to reform its Medicaid program, and ultimately convinced the district court to vacate the consent decree entirely. In a third case, John B. v. Emkes, No. 98-0168 (M.D. Tenn.), we successfully convinced the district court, following a month long trial, to vacate a consent decree that impacted eight separate state agencies and substantially curtailed the State’s ability to design, implement, and adapt multiple aspects of its Medicaid program as applied to children. We successfully defended that victory in the Sixth Circuit. John B. v. Emkes, 710 F.3d. 394 (6th Cir. 2013). As a result of these and other victories, the State has saved billions of dollars. In a fourth case, Wilson v. Long, No. 3:14-CV-01492 (M.D. Tenn. Jan. 23, 2019), following a bench trial, we successfully convinced the district court to vacate a preliminary injunction and permit the State to implement its Medicaid program without oversight from the court or plaintiffs and without any requirements beyond those required by the Medicaid statute and state regulations.
  • St. Luke’s Health Network, Inc. v. Lancaster General Hospital, No. 18-2157 (E.D. Pa.).
    We represent a class of hospitals seeking to recover millions of dollars of payments from a state fund established to reimburse hospitals for a portion of the costs incurred to provide charity care to Pennsylvania’s sickest uninsured patients. We allege that the class members were improperly underpaid because other hospitals inflated their qualifying expenses to recover a larger portion of the finite pot of money available to cover charity care. This case is pending in district court.
  • Shank v. Health Care Services, Inc., 16-2992 (N.D. Ill. 2016).
    We represented a class of individuals afflicted with Hepatitis C whose healthcare insurer denied them access to a miracle cure for their disease. We obtained a settlement seeking to facilitate the ability of every member of the class to access this cure.
  • Pharmaceutical Research and Manufacturers of America v. Thompson, 362 F.3d 817 (D.C. Cir. 2004).
    We successfully represented the State of Michigan in defending a recent initiative whereby it seeks rebates from drug manufacturers in order to control the cost of prescription drugs under its Medicaid and non-Medicaid programs. PhRMA brought suit against the Secretary of Health and Human Services in federal court, challenging his decision to approve the State’s initiative and requesting a preliminary injunction to halt implementation of it. We intervened and the district court granted our motion for summary judgment. The D.C. Circuit affirmed.
  • New York Life Insurance Company v. United States, 190 F.3d 1372 (Fed. Cir. 1999).
    We successfully represented New York Life Insurance Company in its challenge to the Health Care Finance Administration’s application of the Medicare as Secondary Payer Statute to require New York Life to provide primary health care coverage for $15 million in claims of its independent agents that New York Life contends should have been paid by Medicare. The court of appeals vacated the Court of Federal Claims ruling in favor of the agency’s interpretation, and held that the statute did not apply to independent contractors during the relevant period.
  • National Federation of Independent Business v. Sebelius, Nos. 11-393, 11-398, 11-400 (U.S. 2012).
    We filed an amicus brief in challenge to constitutionality of the Affordable Care Act arguing that the individual mandate exceeded the scope of congressional authority and was not severable from the rest of the act.

Prior results do not guarantee a similar outcome.

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