Managed Care Litigation Trends: Insights from Payer and Provider Perspectives (On-Demand Webinar)

Date: 09/30/25

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 60-minute 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 explores:

• 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

Moderator Information:

Evelien Krijnen Hall, Senior Managing Consultant, BRG