Managed Care Litigation Trends: Insights from Payer and Provider Perspectives

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Date: 09/30/25
Time: 2:00-3:00 PM ET

* Please Note: registration closes at 11:59 PM ET the day before the live event. No further registrations will be accepted once registration has been closed *

Live closed captions are available.

Overview: "Managed care litigation continues to evolve rapidly, with courts, regulators, and arbitrators reshaping the landscape in ways that directly impact payers, providers, and patients. This webinar examines significant litigation trends, with insights from a provider-side litigator, a payer-side litigator, and a moderator offering expert analysis and context. The panel will explore:

• ERISA benefit disputes: judicial rulings on medical necessity, wilderness program exclusions, and mental health parity under the MHPAEA.

• Antitrust developments: claims brought by providers challenging alleged unlawful pricing agreements and reimbursement practices targeting out-of-network services.

• Coverage disputes under the ACA: emerging decisions upholding patient rights, including cases involving gender-affirming care.

• Procedural defenses in payer-provider disputes: the latest on exhaustion of remedies, anti-assignment clauses, and estoppel arguments."

Learning Objectives: 

  • Understand recent case law and regulatory developments in managed care litigation and assess their implications for payers, providers, and patients.
  • Evaluate how procedural defenses are being applied in payer-provider disputes and identify practical strategies for leveraging or responding to these defenses.
  • Apply insights from payer, provider, and expert perspectives to anticipate emerging litigation risks, strengthen compliance and contracting practices, and better position stakeholders for success in disputes and negotiations.

Speaker Information:

Jonathan Herman, Managing Member, Herman Law Firm

Jennifer Simmen Lewin, Counsel, King & Spalding

Evelien Krijnen, Senior Managing Consultant, BRG

 

Continuing Education:

CLE: IMPORTANT CHANGE REGARDING CLE CREDIT: We are now working with ABA CLE for our accreditation needs. To earn credits during a live webinar, attendees must be logged into the webinar for at least 75 minutes (of a 90-minute webinar) or 55 minutes (of a 60-minute webinar). Then, they will receive a personalized CLE affidavit from mcle-ahla@americanbar.org. Watch for this email within 7-10 business days. If you do not receive it, please check your spam or junk folders as these emails often end up there. Please note you will fill out one affidavit for the full event. Once you complete the affidavit, you will be able to download your certificate(s) of attendance, and certificates will be emailed to you from mcle-ahla@americanbar.org.

CPE: AHLA is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be addressed to the National Registry of CPE Sponsors, 150 Fourth Avenue North, Nashville, TN 37219-2417. Website: www.nasba.org. For further information, please visit our Continuing Education Page.

AHLA is seeking CPE credits for live webinars. The maximum number of credits available is 1.80.


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