Bloomberg BNA Publishes New Second Edition of “Managed Care Litigation”

Bloomberg BNA has published Managed Care Litigation, Second Edition, a comprehensive reference written to help practitioners who handle managed care disputes focus on key issues and expertly advise their clients in light of the Affordable Care Act (ACA). The book was written in cooperation with the ABA Health Law Section.

Managed Care Litigation, Second Edition provides both a basic overview and a comprehensive examination of the legal issues facing managed care practitioners. The book offers updated practical guidance on:

• Typical disputes, such as benefits coverage issues, utilization management and contractual claims between payors, providers, and patients
• State regulations and insurance administrative processes
• Managed behavioral health care litigation issues and mental health parity
• Antitrust litigation, including unfair trade practices, exclusionary conduct, most-favored nation clauses and anti-competitive actions
• Class action lawsuits and arbitration, settlement and discovery issues
• ERISA litigation and preemption strategies

Important new or expanded topics in the Second Edition include:

• Reimbursement issues, including billing and coding and prompt-pay statutes
• Health plan liability laws, ACA compliance and issues pertaining to medical loss ratios
• External review laws and health insurance exchanges
• Litigating disputes arising under federal health programs, including Medicare, Medicaid, FEHBP and TRICARE, as well as Federal False Claims Act, Anti-Kickback and Stark issues
• Formation and operation of managed care network organizations, ACOs and value-based provider reimbursement and pay for performance issues

This timely reference is an excellent springboard to drafting pleadings or advisory memoranda and is organized so that both in-house and outside managed care counsel and executives can quickly access the information they need, review the legal theories and processes involved and get up to speed on the case law.

The editor-in-chief of Managed Care Litigation, Second Edition is David M. Humiston, a partner with Sedgwick LLP, Los Angeles, CA, who is chairman of the firm’s Healthcare Practice Group. This title is available for sale directly from Bloomberg BNA and also is available on the Bloomberg Law legal research system.

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