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 deep experience in 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
Insights
- Media CoverageHelaine Fingold Quoted in “From RADV Audits to Utilization Concerns, Medicare Advantage Insurers Chart Uncertain ...4 minute read
- Media CoverageEric Neiman Quoted in “Many Medical Treatments Could Be Affected by Supreme Court Transgender Ruling”4 minute read
- Media Coverage
Epstein Becker Green's Health Law Advisor Blog Quoted in “HHS, DOJ Form Joint Working Group to Crack Down on Fraud” ...
2 minute read - Media CoverageJosh Freemire Quoted in “How Medicaid Cuts May Affect Healthcare Deals; GenNx360 Seeks Add-Ons for Pipeline Services ...2 minute read
- Media CoverageWilliam Walters Quoted in “Some Experts Anticipate PrEP, Other Previous USPSTF Recommendations Could See Age Limits” ...2 minute read
- Media CoverageRichard Hughes Quoted in “By Maintaining Obamacare Pillar, Supreme Court Hands Win to HIV Advocates”2 minute read
- Media CoverageRichard Hughes Quoted in “Obamacare Decision Makes Way for Debate on What’s Preventive”2 minute read
- Media Coverage
Richard Hughes Quoted in “Supreme Court Decision on Braidwood Protects Insurance Coverage of Preventive Care” ...
4 minute read - Media CoverageRichard Hughes Quoted in “RFK Jr.’s Real Impact on US Vaccine Supply to Emerge as Panel Meets”2 minute read
- BlogsDOJ Civil Division Announces 2025 Priorities: Promises “Aggressive” False Claims Act Enforcement of Civil Rights ...6 minute read
- PublicationsSupreme Court Upholds Tennessee’s Ban on Gender-Affirming Care20 minute read
- PublicationsCMS’ Pay-for-Performance Paradox3 minute read
- Media CoverageSarah M. Hall Quoted in “Trump’s Focus on Medicare Advantage Fraud Poses Enforcement Test”3 minute read
- PublicationsCMS Proposes to Close Perceived Loophole in Medicaid Health Care-Related Tax Regulations14 minute read
- Media CoverageMelissa Jampol Quoted in “DOJ Sweetens Self-Disclosure Pot; Health Fraud Ranks High in White-Collar Enforcement Plan” ...9 minute read
- Media Coverage
Christine Burke Worthen Featured in AHLA’s Speaking of Health Law Podcast, “Medicare Advantage: Navigating ...
2 minute read - Media CoverageGary Baldwin, Karl Thallner Featured in “2 Health Care Regulatory Attorneys Move to Epstein Becker Green”2 minute read
- PublicationsFTC and DOJ Direct Agency Heads to Identify Anticompetitive Regulations for Elimination—Including in Health Care ...2 minute read
- BlogsFederal Regulators Announce Non-Enforcement of the 2024 Rule for Mental Health Parity13 minute read
- PublicationsMeasles Cases Top 1,000: A Crisis of Complacency2 minute read
- Media CoverageGary Baldwin, Karl Thallner Featured in “Healthcare Duo Joins Epstein Becker Green”2 minute read
- Firm AnnouncementsEpstein Becker Green Welcomes Seasoned Health Care Regulatory Attorneys Gary L. Baldwin and Karl A. Thallner, Jr ...3 minute read
- Media Coverage
Richard Hughes Featured in Healthcare Matters, “Immunization at a Crossroads: Experts Weigh In from the World Vaccine ...
4 minute read - BlogsCMS Issues CY 2026 MA & Part D Rate Announcement, Final Rule on CY 2026 Policy and Technical Changes to Programs, While Seeking ...13 minute read
- PublicationsThe Future of Preventive Care Depends on the Supreme Court’s Reading of Two Words2 minute read
- BlogsA Common Denominator Governs the Medicare Fraction - SCOTUS Today5 minute read
- Media CoverageRichard Hughes Quoted in “Why Journalists Need to Explain the Value of No-Cost Preventive Care”7 minute read
- Media CoverageWilliam Walters Quoted in “Ruling Could Give Kennedy More Power Over Health Care Coverage”4 minute read
- Media CoverageRichard Hughes Quoted in “ACA Preventive Care Case Reaches Supreme Court”4 minute read
- Media Coverage
What's at Stake as Oral Arguments Are Presented in the Braidwood Case? Q&A with Richard Hughes, IV
4 minute read - Media CoverageRichard Hughes Quoted in “Supreme Court Grapples with Challenge to ObamaCare Preventive Care Panel”6 minute read
- Media CoverageWilliam Walters Quoted in “Supreme Court Appears Willing to Save ACA Preventive Services Task Force”3 minute read
- Media CoverageRichard Hughes Quoted in “Supreme Court to Hear Challenge to Obamacare Rule on Free Preventive Care”4 minute read
- Media CoverageRichard Hughes Quoted in “‘At the Mercy of Insurance Companies’: Supreme Court Braces for ACA Preventive Coverage ...4 minute read
- PublicationsPutting Price Transparency into Perspective2 minute read
- Media CoverageHelaine Fingold Quoted in “'Watching the Clues': Uncertainty Clouds Medicare Broker Conference”3 minute read
- BlogsA Closer Look at Proposed Changes to Medicare Advantage in the “No UPCODE Act”13 minute read
- BlogsPodcast: Criminal Health Care Fraud Enforcement - Projections for 2025 and Beyond – Diagnosing Health Care2 minute read
- Media CoverageRichard Hughes Quoted in “Supreme Court to Weigh Medicaid Cutoff for Planned Parenthood”2 minute read
- Media CoverageJackie Selby Featured in “Member Spotlight”2 minute read
- Media CoverageRichard Hughes Quoted in “USPSTF Taps New Chair, Vice Chair; Quiet on Potential Changes”2 minute read
- Media Coverage
Jenny Nelson Carney Featured in AHLA’s Speaking of Health Law Podcast, “Top Ten 2025: Gender Affirming ...
2 minute read - Media CoverageHelaine Fingold Quoted in “MedPAC Members Will Hear Out Agents, Brokers After Slamming `Flawed System’”2 minute read
- Media CoverageKate Heffernan, Robert Wanerman Quoted in “HHS Comment Reversal Sets Stage for Quick Policy Changes”2 minute read
- Media CoverageSarah M. Hall Quoted in “Criminal Health Care Fraud Enforcement Expected to Remain Robust”2 minute read
- PublicationsWhat Does the Phrase “Resulting From” Mean? Circuit Courts Split on Standard for Determining When an AKS Violation Is a ...16 minute read
- PublicationsACIP’s Upcoming Meningococcal Recommendations: Added Complexity, Reduced Choice1 minute read
- Media Coverage
Karen Mandelbaum Interviewed in On Background Podcast
1 minute read - PublicationsProposed HIPAA Security Rule Updates May Significantly Impact Covered Entities and Business Associates20 minute read
- Media Coverage
Richard Hughes Discusses Why Payer Responsibility for Preventative Services May Hinge on Braidwood Management Inc. v ...
4 minute read