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Healthcare Litigation

We provide trial counsel to numerous healthcare providers in both the administrative context and before the state and federal courts. Representative engagements include insurance/payer reimbursement disputes (both by in-network and out-of-network providers), healthcare fraud claims, government investigations, fraudulent lien suits, antitrust claims, commercial contract matters, and False Claims Act cases, among others

Overview

Thompson & Knight has substantial expertise in the field of healthcare litigation. We have provided trial counsel to numerous healthcare providers in both the administrative context and before the state and federal courts. Representative engagements include insurance/payer reimbursement disputes (both by in-network and out-of-network providers), healthcare fraud claims, government investigations, fraudulent lien suits, antitrust claims, commercial contract matters, and False Claims Act cases, among others.

We protect the rights of healthcare providers, both when they have significant claims against others and when they themselves may be threatened with investigations or lawsuits related to their practice. Thompson & Knight is one of the few law firms in Texas who solely represents healthcare providers and not payers in managed care litigation, allowing us to focus the entirety of our healthcare litigation practice on the unique legal challenges providers face.

Our attorneys have handled and successfully resolved numerous affirmative claims on behalf of healthcare providers, including:

  • Disputes with insurance companies and other payers for proper and complete reimbursement for both in and out-of-network providers
  • Fraud and defamation claims against payers for inaccuracy and bad acts in handling insurance claims
  • Claims for violation of the Texas Prompt Pay Act, where payers have failed to comply with the law in their handling of in-network provider claims – we currently represent more than 30 clients in over 100 of these cases
  • Claims under ERISA for an insurer’s failure to pay a provider’s claims
  • RICO claims against insurers related to fraud/misconduct in their efforts to avoid payment to providers
  • Contractual disputes and employment issues between provider entities and individual providers
  • Contractual disputes between providers and payers

Thompson & Knight attorneys have also resolved matters in which healthcare providers have been forced to defend themselves in litigation, including:

  • Fraud and abuse claims made by insurers or administrators against healthcare providers related to billing practices
  • Qui tam or False Claims Act cases in which a whistle blower makes allegations implicating a healthcare provider in wrongdoing
  • ERISA suits brought by payers against healthcare providers for recoupment of amounts alleged to be erroneously paid
  • Allegations against providers related to federal and state anti-kickback provisions or Stark laws
  • Antitrust investigations and lawsuits (both governmental and private)
  • Lawsuits against institutional providers regarding privilege determinations
  • Employment and contractual disputes between institutional providers and employees/contractors

Our attorneys also have extensive experience and abilities representing healthcare providers and other individuals and entities who may find themselves either the target of or merely a third party caught up in a government or private investigation. Thompson & Knight attorneys have represented healthcare providers in each of these contexts as well:

  • Governmental fraud and abuse investigations
  • Antitrust investigations and suits (both governmental and private)
  • Allegations of Stark law or anti-kickback violations
  • Peer review hearings
  • Licensure denial or revocation
  • Regulatory and administrative actions
  • Responses to third-party, administrative, and grand jury subpoenas, and civil investigative demands received from state and federal agencies

Named among the top firms in Texas for Healthcare in Chambers USA 2019 by Chambers and Partners

Received a first-tier ranking in Dallas for Healthcare Law in U.S. News - Best Lawyers® “Best Law Firms” 2019