Overview
Epstein Becker Green was one of the innovators of, and is a prominent law firm in, managed care delivery systems.
The firm has extensive experience working with managed care organizations, and firm attorneys have provided key technical advice to Congress, federal agencies, and states throughout the development, passage, and implementation of managed care legislation. Epstein Becker Green has provided hundreds of managed care organizations with dependable assistance in developing successful organizational responses to managed care operational and regulatory issues and has served as counsel to the leading professional trade associations for managed care organizations. The firm's experience base includes, for example, managed care clients focused in the following sectors: dental, vision, occupational health, behavioral workers compensation, pharmaceutical, and "consumer directed" sectors, to name a few.
The firm also has had long experience with the application of managed care financing and delivery to beneficiaries of governmental programs such as Medicaid, Medicare, and TRICARE. Our clients have long included contractors in each of these programs so that we bring a seasoned perspective to the problem faced by Medicare Part C and D contractors. We work with these and other clients on all aspects of regulating compliance and risk management.
Services/Scope of Practice
Epstein Becker Green provides complete legal support for managed care organizations. Our services include:
- Sector advice to private equity investors and lenders
- Counseling as to state and national regulatory compliance
- Counseling with respect to state licensure and federal contracting issues
- Representation in regulatory investigations
- Representation in mergers and acquisitions
- Public policy analysis
- Strategic legal plans for developmental stage companies
- Litigation of managed care issues
- Contract negotiations
- Compliance plan developmental and execution
- Provider contracting
- Advice on Medicare, Medicaid, Federal Employee Health Benefits Program, TRICARE contract negotiation, and regulatory compliance programs
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Insights
- Publications
Will Religious Freedom Claims Trump Public Health? Braidwood and HIV Prevention
2 minute read - Media CoverageRichard Hughes Quoted in “ObamaCare Faces Key Hearing After Texas Ruling”2 minute read
- BlogsVideo: Braidwood v. Becerra – Challenging the Affordable Care Act’s Preventive Services Coverage Provision – ...2 minute read
- Media CoverageRichard Hughes Quoted in “4 Argument Sessions Benefits Attys Should Watch in March”4 minute read
- Media CoverageRichard Hughes Quoted in “Affordable Care Act Preventive Services Under Threat: Previewing Braidwood Oral Arguments” ...4 minute read
- Media CoverageRichard Hughes Quoted in “Doc Pay Patch Could Emerge in Scaled-Back Health Package; Budget Talks Continue”2 minute read
- Media CoverageMarjorie Scher Quoted in “Citing U.S. Supreme Court Decision, Health System Sues Medicare Advantage Plan for Past 340B ...4 minute read
- Media CoverageDavid Shillcutt Quoted in “Growth in Outpatient Programs Signals Opportunities for MFTs, MHCs”2 minute read
- Publications
Striking a Balance: The Supreme Court and the Future of Chevron Deference
27 minute read - Media CoverageHelaine Fingold Quoted in “No Surprises IDR Portal Is Back; Prepare for New Info Requirements”2 minute read
- PublicationsNew Coverage, Delivery, and Payment for Health-Related Social Needs Services Under New York’s Approved 1115 Medicaid ...13 minute read
- PublicationsClinical Preventive Guidelines Should Foster Patient Access: A Reply to Killelea and Johnson6 minute read
- Media CoverageElizabeth Harris, ’11, Featured in California Western School of Law Alumni News2 minute read
- Media CoverageAmy Lerman Quoted in “Patient Care, Policy & More: A Look at This Year’s Virtual Care Trends”5 minute read
- PublicationsHospital and MA Plan Considerations for CMS Final Rule to Remedy 340B Drug Payment Policy11 minute read
- PublicationsTop Ten Issues in Health Law 2024—Major Expansion of Federal Regulation of Managed Care Through the Mental Health Parity ...6 minute read
- Media CoverageRichard Hughes Quoted in “The RSV Shot for Babies Was Supposed to Save Lives. Then Nobody Could Get It.”13 minute read
- BlogsPodcast: Health Equity – Behind the Buzzwords – Diagnosing Health Care2 minute read
- PublicationsMedicare Advantage, Part D, and More: Proposed Rule Outlines Significant Policy and Technical Changes for CY 2025 ...35 minute read
- PublicationsBraidwood v Becerra’s Vaccine Access Threat3 minute read
- Publications
In Genesis Case, South Carolina District Court Scraps HRSA Interpretation of “Patient” Under 340B Statute
9 minute read - Media CoverageConnie Wilkinson Quoted in “Stelara Biosimilar Tests Market Impact of Drug Price Program”3 minute read
- PublicationsPaving the Way for Prevention Over the Counter3 minute read
- PublicationsQuadrivalent vs Trivalent Influenza Vaccines: Not a Simple Switch2 minute read
- Media CoverageRichard Hughes Quoted in “Coverage, Supply Issues Dampen Promise of New RSV Immunizations”3 minute read
- PublicationsCMS Seeks Stakeholder Feedback About Medicare Transaction Facilitator Services for the Medicare Drug Price Negotiation ...4 minute read
- PublicationsPreventive Antibody Products Are Immunizations2 minute read
- Media CoverageRichard Hughes Quoted in “Webinar Highlights Recommendations to Improve Disparities in CRC Screening”3 minute read
- PublicationsCalifornia Enacts Statute That Furthers Efforts to Move Toward a Unified Health Care Financing System11 minute read
- Media CoverageRichard Hughes Quoted in “RSV Vaccines Aren’t Covered by Medicare for These Vulnerable Groups”2 minute read
- Media CoverageRichard Hughes Quoted in “Opinion: It Shouldn’t Be So Hard for Older Adults to Receive the RSV Vaccine”2 minute read
- PublicationsRecent Developments in Federal and State Fraud and Abuse Investigations2 minute read
- Publications
Checking In on How SuperValu Has Altered FCA Litigation
4 minute read - Media CoverageHelaine Fingold Quoted in “Reports of Cold Calling, False Promises Put Medicare Marketers on Alert”3 minute read
- PublicationsState Regulation of Pharmacy Benefit Managers: Tenth Circuit Holds That ERISA and Medicare Part D Preempt Key Parts of ...25 minute read
- Media CoverageRichard Hughes Quoted in “New RSV Vaccines Aren’t Covered by Some Health Insurance Plans”3 minute read
- Publications‘Vaccines for Children’ at 30: Lessons in Bipartisanship and Cooperative Federalism3 minute read
- Media CoverageDavid Shillcutt Quoted in “3 Takeaways from Biden's Mental Health Parity Proposal”4 minute read
- PublicationsAdditional Withdrawals of Long-Standing Guidance and Newly Proposed Merger Guidelines2 minute read
- Media CoverageRachel Snyder Good Featured in “The Top Mid-Law People Moves of 2023 So Far”2 minute read
- PublicationsCMS Announces the Making Care Primary Model, a Multistate Initiative to Strengthen Primary Care9 minute read
- PublicationsVaccines Deserve Immunity from the IRA’s Pricing Provisions2 minute read
- PublicationsCMS Releases Its List of 43 Part B Rebatable Drugs for Q3: Inflation Reduction Act Updates7 minute read
- PublicationsManufacturers Must Request Small Biotech Exception by July 3: Inflation Reduction Act Updates4 minute read
- Media CoverageRichard Hughes Quoted in "HIV Prevention Drug Uptake Threatened in Obamacare Battle"2 minute read
- Media CoverageEpstein Becker Green Litigators Featured in “$91M Award: Plaintiffs Win on Claims That UnitedHealthcare Stiffed Medical ...6 minute read
- Media CoverageRichard Hughes Quoted in “Could Government Drug-Price Negotiations Sound the Death Knell for Biotech Stocks?” ...3 minute read
- BlogsThe Legal Battle Over Mifepristone10 minute read
- Media CoverageRichard Hughes Quoted in “Biden's Next Steps on Preventive Services Coverage”3 minute read
- PublicationsIs CMS Ignoring the Realities of Biopharmaceutical Costs?2 minute read