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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Focus Areas
Industries
Trending Issues
Experience
- Mental Health Parity
Advised State Medicaid Agency on Completion of Analysis for Mental Health Parity and Addiction Equity Act (MHPAEA) Compliance for Medicaid Program - Mental Health Parity
Provided Counsel to National Group Commercial Insurer with the Use of Third-Party Administrators Regarding Mental Health Parity Compliance
Contacts
Member of the Firm
Board of Directors / Member of the Firm
Member of the Firm
Media
Events
Past Events
- December 2024
- Fall 2024
- Fall 2024
Insights
Insights
- PublicationsMedicare Coverage of Antiobesity Medicines1 minute read
- Media CoverageRichard Hughes Featured in “‘How Far Will RFK Go?’ 2 Experts Talk Kennedy’s Potential Impact on Child Health” ...4 minute read
- BlogsPodcast: Health Policy Update: Impact of the 2024 U.S. Elections – Diagnosing Health Care2 minute read
- Media CoverageRichard Hughes Explores the Impact of President-Elect Trump’s Nomination of Robert F. Kennedy Jr. as Secretary of Health ...13 minute read
- Media CoverageHelaine Fingold Quoted in “In a Twist, Medicare Advantage Insurers Try to Avoid Selling Plans”2 minute read
- Media CoverageRichard Hughes Quoted in “5 Ways Trump's Election Could Change Employee Benefits”2 minute read
- Media CoverageDavid Shillcutt Quoted in “Trump's Win Endangers Slew of Biden-Era Employee Benefits Rules”2 minute read
- Media CoverageStuart M. Gerson Quoted in “HHS Hospital Pay Formula at High Court: 4 Things to Know”3 minute read
- Media CoverageErin Sutton Quoted in “3 Things to Know About Proposed OTC Contraception Regs”3 minute read
- PublicationsThe US Supreme Court and the Uncertain Future of Preventive Care4 minute read
- PublicationsFinal Mental Health Parity Rules Released: Next Steps for Employers8 minute read
- BlogsOCR Withdraws Appeal of District Court Order Declaring Unlawful and Vacating the “Proscribed Combination” Portion of ...4 minute read
- PublicationsApplication of New Mental Health Parity Rules to Provider Network Composition and Reimbursement: Perspective and Analysis ...14 minute read
- BlogsVideo: New DOL Guidance - ERISA Plan Cybersecurity Update - Employment Law This Week3 minute read
- Media CoverageRichard Hughes Quoted in “Gov't Looks to High Court to Preserve Free Preventive Care”2 minute read
- PublicationsMental Health Parity: Federal Departments of Labor, Treasury, and Health Release Landmark Regulations12 minute read
- Media CoverageRichard Hughes Quoted in “DOJ Asks SCOTUS to Reverse Braidwood Ruling, Uphold ACA’s Preventative Mandate” ...3 minute read
- Media CoverageDavid Shillcutt Quoted in “3 Atty Takeaways on Mental Health Parity Final Rules”3 minute read
- Media CoverageKevin Malone Quoted in “Mental Health Parity Rule Pushes Employers to Rethink Status Quo”3 minute read
- Media CoverageRichard Hughes Quoted in “CMS Signals Preventive Services Coverage Update with Pending Rule”3 minute read
- Media Coverage
Richard Hughes Quoted in “DOJ Will Ask SCOTUS to Take Up Braidwood”
3 minute read - Media CoverageMarjorie Scher Quoted in “Will Medicaid Incarceration Waivers Hit 'Cutting Room Floor'?”2 minute read
- PublicationsInteragency Strike Force on Unfair and Illegal Pricing Holds First Public Meeting1 minute read
- Media CoverageChristine Worthen Featured in “Beltway Moves”1 minute read
- Media CoverageEpstein Becker Green Adds Healthcare Attorney Christine Burke Worthen in Washington, DC2 minute read
- Firm AnnouncementsEpstein Becker Green Adds Health Care Regulatory Firepower with Attorney Christine Burke Worthen in Washington, DC ...2 minute read
- PublicationsFTC Releases Controversial Interim Staff Report on PBMs’ Purported Impact on Drug Prices3 minute read
- PublicationsInsurers in the Crosshairs Over AI1 minute read
- PublicationsProposed FTC Budget Signals Continued Enforcement Initiatives2 minute read
- Publications
Supreme Court Alters the Administrative State: Loper and Relentless Decision Shifts Authority from Administrative ...
13 minute read - Media CoverageDavid Shillcutt Quoted in “Illinois Bans Step Therapy, Health Plan Prior Authorization for Emergency Mental Health ...3 minute read
- Media CoverageHelaine Fingold Quoted in “MAOs, Brokers, Agents Get Relief with Legal Pause on Policy Changes”2 minute read
- BlogsPodcast: Down Goes Chevron: A 40-Year Precedent Overturned by the Supreme Court – Diagnosing Health Care2 minute read
- Media CoverageRichard Hughes, Raja Sékaran Quoted in “‘Chaotic’ Health Care Rulemaking Looms After Supreme Court Hamstrings ...3 minute read
- Media CoverageHelaine Fingold Quoted in “Court Pauses CMS Broker Compensation Rule for Medicare Advantage Plans”3 minute read
- BlogsDOJ Criminal Fraud Section’s Annual Health Care Fraud Enforcement Action: “We Are a Target-Rich Environment” ...20 minute read
- Media CoverageDennis Sapien-Pangindian Quoted in “Info Blocking ‘Disincentives’ Rule Brings Penalties; Data-Sharing ...2 minute read
- Media CoverageRichard Hughes Quoted in “Insurance Wouldn’t Pay for His Vasectomy. Such Birth Control Coverage May Become More ...2 minute read
- PublicationsNew Anti-Obesity Medications Should Be Considered Preventive Health Care2 minute read
- Media Coverage
Robert Wanerman Quoted in “Health Regulators Likely to Tread Carefully Post-Chevron”
2 minute read - PublicationsBraidwood v Becerra: The Threat to Preventive Services Just Got Worse3 minute read
- Media Coverage
Richard Hughes Quoted in “Supreme Court Overrules Chevron Deference, Dealing Blow to Federal Healthcare Agencies” ...
3 minute read - Media CoverageRichard Hughes Quoted in “Feds' 5th Circ. Win on Preventive Care May Imperil ACA”3 minute read
- Media CoverageRichard Hughes Quoted in “Obamacare Mandate Battle Shifts After Appeals Court Speaks”3 minute read
- Media CoverageRichard Hughes Quoted in “Court Upholds ACA’s Free Preventive Services Mandate”3 minute read
- Media CoverageRichard Hughes Quoted in “‘A Mixed Bag’: Fifth Circuit Rules on ACA Preventive Services Legal Case”3 minute read
- Media CoverageRichard Hughes Quoted in “News Briefs: Court Upholds ACA Preventive Services Coverage Mandate, for Now”2 minute read
- Media CoverageRichard Hughes Quoted in “Appeals Court Finds 'Obamacare' Pillar Unconstitutional in Suit Over HIV-Prevention Drug” ...3 minute read
- Media CoverageRichard Hughes Quoted in “Fifth Circuit Maintains ACA Preventive Mandate; but Remands Vaccine, Birth Control” ...1 minute read
- Media CoverageErin Sutton Quoted in “SCOTUS Mifepristone Ruling Leaves Employers in Coverage Quandary”3 minute read