Managed Care Litigation & Arbitration

Wolfe | Pincavage represents providers in litigation and arbitration proceedings against health plans, insurers, preferred provider organizations and other managed care organizations.  Our extensive managed care knowledge allows us to develop comprehensive and efficient representation for health care companies in litigation.  We work closely with our health care clients to develop litigation strategies that best serve their business and legal objectives.

We have litigated managed care disputes involving issues such as:

•           Contract interpretation
•           Contract termination
•           Out of network disputes over usual and customary rates
•           Disputes against international payors involving questions of jurisdiction
•           ERISA litigation involving adverse benefit determinations
•           Multi-party disputes involving rental networks
•           Reference based pricing
•           Incorrectly loaded rates
•           Late payments
•           Coordination of benefits issues
•           Pre-payment review of claims and payment process related disputes
•           Improper deductions and recoveries
•           Improper payment policies
•           And many other issues.




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