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HEALTH CARE INSURANCE

As health care providers explore new compensation and reimbursement models, many are engaging in business opportunities that require knowledge of, and experience in, Medicare and Medicaid statutes and regulations, as well as state insurance laws. Over the years our attorneys have worked with a number of Medicare and Medicaid managed care plans gaining an extensive working knowledge of the laws governing such plans.

Our attorneys also routinely:

  • Interact with state Departments of Insurance on our clients’ behalf to assist with licensure requests, insurance form filings, and the acquisitions and divestitures of health plans
  • Establish partnerships with payers and employers on risk contracting, allowing providers to assume accountability for care in acceptable risk constructs
  • Analyze current relationships for affiliated networks and integrated delivery systems relating to managed care contracting and other risk arrangements (e.g., Medicare shared savings programs, bundled payment for care improvement initiatives)
  • Assist in researching and analyzing state agent and producer insurance laws and in maintaining pharmacy benefits manager, third-party administrator, and utilization review licenses

Our attorneys have long represented commercial and managed care plans in many types of lawsuits. We have substantial experience defending claims arising from denial of a claim and third-party administrator decisions. We have also represented managed care organizations in lawsuits against governmental agencies and other complex contract actions.

Publications

Illinois legislature makes substantial limiting changes to state law on non-compete and non-solicitation agreements

You just received a grand jury subpoena. Now what?

EEOC issues new guidance on COVID-19 vaccinations in the workplace

Non-practicing entities target electronic health records apps in patent litigation

What can recent FCA decisions tell us about the Seventh Circuit pleading standard for health care billing fraud claims?

Missouri legislature passes new protections for businesses from COVID-19 suits

The NCAA Implements a Four Corners Offense As it Postpones NIL Rule Changes

OSHA issues new guidance on face coverings in light of COVID-19

Federal agencies announce expedited antitrust procedures for COVID-19 public health efforts

Seven things employers should know about Medicare for All

Surprise billing legislation: What employers need to know

When should you terminate a defined benefit plan? Four influential factors

Bifurcated trials: A road map for better results for insurers facing non-ERISA disability claims

5 takeaways from the employee ERISA win in McMillan

In California, when is a ‘worker’ considered an ‘employee’?

Criminal antitrust prosecutions still loom for employers with ‘no-poaching,’ ‘wage-fixing’ agreements

Supreme Court clarifies definition of ‘church plan’ under ERISA

Grant and cooperative-agreement recipients: Are your procurement standards compliant yet?

21st Century Cures Act overrules IRS guidance on HRAs, enhances enforcement of Mental Health Parity Act

5 tips for environmental due diligence in business transactions

Recent guidance issued on mental health parity and tobacco cessation programs

Missouri to join Right to Work ranks: Is the fight over or just warming up?

EEOC issues guidance on new wellness notice mandated for 2017

Texas overtime ruling directly affects California employers

Are HR employees ‘investment advisors’ under the DOL’s fiduciary rule?

Did you consider the COBRA implications of your severance arrangement?

Key considerations for representation and warranty insurance

New Illinois law prohibits non-competition agreements with low-wage employees

IRS releases updated safe harbors for management contracts in tax-exempt bond-financed projects

New OSHA reporting and anti-retaliation rules

IRS releases final forms for Health Care Reform reporting

Two key legislative developments impact wellness plans, non-qualified deferred compensation plans

IRS guidance on the application of the Affordable Care Act’s market reform provisions to HRAs and FSAs

Health care reform reporting requirements: Final rules

Health FSA carryover amendments - Proceed with caution

U.S. Supreme Court strikes down DOMA: What it means for plan sponsors

Blog Posts

Blog Browse: What can recent FCA decisions tell us about the Seventh Circuit pleading standard for health care billing fraud claims?

What you need to know about CMS’s recovery of COVID-19 Accelerated and Advance Payments

Permanent changes finally coming to telehealth

Fifth Circuit vacates $4.3M HHS enforcement penalty for HIPAA violations

HHS provides updated guidance on Provider Relief Fund reporting requirements

OIG issues special fraud alert on health care speaker programs

DOJ continues to pursue health care fraud during COVID-19 pandemic

Additional updates to the Provider Relief Fund

Provider Relief Fund updates: Phase 3 distribution and reporting requirements

State Emergency Declarations: When do they expire and what impact do they have for health care facilities and providers?

TCLE

Better Together? Competition, Price Gouging and Other Antitrust Issues Raised by the COVID-19 Pandemic

Ethics and Cybersecurity

Overtime Law 2016 – Expanded New Rule: What It Means for You

Prevent the Cloud from Putting Your Health Data at Risk

News

Thompson Coburn is Texas proud after first year in Dallas

Health care litigator Mackenzie Wallace joins Thompson Coburn in Dallas

Thompson Coburn client Charles Rice wins 2020 Nobel Prize for Hepatitis C Virus discoveries

Nicole Jobe named a 2020 Missouri Up & Coming Lawyer

Thompson Coburn announces new podcast: Talking Pop Health with Eric Tower

Eric Tower joins Thompson Coburn’s Chicago office

Congratulations to our 14 ‘Lawyers of the Year’ for 2020

Claire Schenk imparts life (and rock climbing) advice in UMSL commencement speech

Tonya Oliver Rose rejoins Thompson Coburn’s health care practice

Congratulations to our 14 'Lawyers of the Year' for 2018

Evan Goldfarb named a 2017 Women’s Justice Award winner

Thompson Coburn named among top 30 law firms for client service

St. Louis Business Journal honors Thompson Coburn for outstanding wellness initiatives

A merger story: Tom Minogue and Jack Musgrave discuss 20 years as Thompson Coburn

Claire Schenk to moderate Missouri Bar Health and Hospital Administration panel presentation

Thompson Coburn earns corporate counsel recommendations five years running in national report

Thompson Coburn earns eight national top-tier rankings in U.S. News ‘Best Law Firms’ survey

Thompson Coburn represents issuer in 2014 Health Care Deal of the Year

Christina Randolph joins Thompson Coburn’s health care practice group

Claire Schenk to speak at 10th Annual ABA National Institute on False Claims Act

Thompson Coburn secures Illinois appellate victory for community hospital

Missouri Supreme Court sides with Mercy Hospital St. Louis in class action over billing practices

Jan Paul Miller quoted in St. Louis Business Journal on Glaxo health care fraud settlement

Thompson Coburn handled The Bond Buyer’s 2011 Health Care Deal of the Year

Associate
St. Louis

Tyler leverages his extensive practical financial background to assist clients with a variety of corporate and securities matters and finance activities.

Tyler leverages his extensive practical financial background to assist clie...

Tyler Ash
Associate
Chicago

Raquel focuses her practice on corporate and regulatory matters within the health care sector.

Raquel focuses her practice on corporate and regulatory matters within the ...

Raquel Boton
Partner
St. Louis

Cathy focuses her practice on employee benefits, taxation and closely-held businesses.

Cathy focuses her practice on employee benefits, taxation and closely-held ...

Cathy Conrad
Partner
St. Louis

Dan handles various types of complex litigation, including business, tort, product liability, intellectual property, and class action defense.

Dan handles various types of complex litigation, including business, tort, ...

Dan Cox
Partner
St. Louis

Jim is an experienced real estate strategist and negotiator who counsels companies on a broad range of real estate matters, including acquisitions, dispositions, develo...

Jim is an experienced real estate strategist and negotiator who counsels ...

Jim Dillon
Partner
Dallas

Jenny is an experienced, strategic, trial lawyer who focuses her practice on health care, white-collar fraud and complex commercial litigation.

Jenny is an experienced, strategic, trial lawyer who focuses her practice o...

Jennifer Ecklund
Partner
St. Louis

Jeff helps all types of businesses navigate complex litigation, arbitration, class action, regulatory, and transactional matters in venues across the country.

Jeff helps all types of businesses navigate complex litigation, arbitration...

Jeff Fink
Partner
St. Louis

Jim serves as a key advisor to regional medical groups on the full spectrum of business and regulatory issues they encounter while providing medical services.

Jim serves as a key advisor to regional medical groups on the full spectrum...

Jim Fogle
Partner
St. Louis

Larry has extensive experience in cases involving shareholder rights, business valuations, fiduciary duty claims, and other contract and business disputes.

Larry has extensive experience in cases involving shareholder rights, busin...

Larry Friedman
Partner
St. Louis

Suzanne is a versatile litigator who finds creative solutions for clients facing difficult and protracted legal battles.

Suzanne is a versatile litigator who finds creative solutions for clients f...

Suzanne Galvin
Partner
St. Louis

For more than 20 years, Evan has served as a trusted advisor to hospitals, health care systems, long-term care facilities, health plans, physicians, and other businesses ...

For more than 20 years, Evan has served as a trusted advisor to hospitals, ...

Evan Raskas Goldfarb
Partner
Chicago

Jay serves as a critical business partner and advisor for a variety of companies, from startups to multi-level international organizations.

Jay serves as a critical business partner and advisor for a variety of comp...

A. Jay Goldstein
Partner
Washington, D.C.

Hospitals, health systems, physicians and other health care clients look to Milada, an attorney and registered nurse, for critical assistance on a range of complex regula...

Hospitals, health systems, physicians and other health care clients look to...

Milada Goturi
Partner
St. Louis

Ed is a veteran litigator and head of the Firm's Antitrust Practice Group.

Ed is a veteran litigator and head of the Firm's Antitrust Practice Group.

Ed Harvey
Partner
St. Louis

Joy advises health systems, health plans, group purchasing organizations, physician groups, and other health care entities on a wide range of health care legal issues.

Joy advises health systems, health plans, group purchasing organizations, p...

Joy Harris Hennessy
Partner
St. Louis

Nicole advises health care providers and health plans on structuring transactions and analyzes health care regulatory issues with an eye toward effective, proactive compl...

Nicole advises health care providers and health plans on structuring transa...

Nicole Jobe
Partner
St. Louis

For more than 30 years, Lori has been helping clients solve some of the most challenging employee benefit problems.

For more than 30 years, Lori has been helping clients solve some of the mos...

Lori Jones
Partner
Chicago

Rob is a pragmatic, solution-oriented advisor who guides companies through major transactions as well as provides comprehensive advice on their day-to-day operations and ...

Rob is a pragmatic, solution-oriented advisor who guides companies through ...

Rob Kamensky
Associate
St. Louis

Kevin provides strategic legal counsel to health care clients on a broad spectrum of matters.

Kevin provides strategic legal counsel to health care clients on a broad sp...

Kevin Kifer
Associate
St. Louis

As a former health care executive, April strongly connects to the complex issues facing health care clients.

As a former health care executive, April strongly connects to the complex i...

April Kirkley
Partner
St. Louis

Brian practices in the Firm's business litigation and health care litigation areas, where he represents both plaintiffs and defendants in complex commercial litigation an...

Brian practices in the Firm's business litigation and health care litigatio...

Brian Lamping
Partner
St. Louis

Michael's practice is focused on providing practical, comprehensive solutions that meet the business goals of clients in the employee benefits area of human resources law...

Michael's practice is focused on providing practical, comprehensive solutio...

Michael Lane
Partner
St. Louis

Rick advises companies and individuals on a variety of federal (domestic and international), state and local tax matters.

Rick advises companies and individuals on a variety of federal (domestic an...

Rick Lawton
Partner
St. Louis

Tom is a veteran M&A and corporate finance attorney who provides clients with common-sense solutions to address complex transactional issues.

Tom is a veteran M&A and corporate finance attorney who provides client...

Tom Litz
Partner
New York

Steve represents financial institutions, businesses and constituencies in federal and state courts throughout the United States in a wide variety of major commercial disp...

Steve represents financial institutions, businesses and constituencies in f...

Steven Mandelsberg
Partner
St. Louis

Greg represents clients in mergers and acquisitions and sophisticated securities offerings, and offers advice on the wide range of regulatory and compliance issues affect...

Greg represents clients in mergers and acquisitions and sophisticated secur...

Greg Mennerick
Partner
St. Louis

Jan is a former United States Attorney with extensive trial experience who represents companies and individuals in major litigation and regulatory actions.

Jan is a former United States Attorney with extensive trial experience who ...

Jan Paul Miller
Partner
St. Louis

Steve serves as a trusted advisor to financial institutions engaged in all types of public finance and lending transactions.

Steve serves as a trusted advisor to financial institutions engaged in all ...

Steve Mitchell
Associate
St. Louis

Lauren draws on her extensive background in the health care industry to support clients in a variety of business and regulatory matters.

Lauren draws on her extensive background in the health care industry to sup...

Lauren Pair
Counsel
Washington, D.C.

Jennifer provides counsel to a broad range of clients in the health care and life sciences industries, including institutional providers, medical practices, health system...

Jennifer provides counsel to a broad range of clients in the health care an...

Jennifer Pike
Partner
St. Louis

Chuck is a creative and highly efficient employment litigator and advisor to private and public sector employers across a wide spectrum of industries.

Chuck is a creative and highly efficient employment litigator and advisor t...

Chuck Poplstein
Associate
St. Louis

Elise has experience in both trials and appeals, representing clients across the country in complex commercial litigation, as well as government investigations.

Elise has experience in both trials and appeals, representing clients acros...

Elise Puma
Partner
St. Louis

Clients look to Christina for practical solutions to their complex regulatory compliance problems.

Clients look to Christina for practical solutions to their complex regulato...

Christina Randolph
Partner
St. Louis

Tonya provides sensible, strategic and holistic guidance to health care clients related to health care regulatory and compliance issues, government investigations and tra...

Tonya provides sensible, strategic and holistic guidance to health care cli...

Tonya Oliver Rose
Partner
St. Louis

As a former Assistant United States Attorney, Claire advocates for clients in the areas of health care fraud and abuse, False Claims Act litigation and other complex whit...

As a former Assistant United States Attorney, Claire advocates for clients ...

Claire Schenk
Partner
Chicago

Eric advises health care clients on a wide range of business-critical transactional and operational matters.

Eric advises health care clients on a wide range of business-critical trans...

Eric Tower
Partner
St. Louis

Brent helps his clients navigate the complexities of mergers, acquisitions, financings, and other significant corporate transactions from initial negotiation through exec...

Brent helps his clients navigate the complexities of mergers, acquisitions,...

Brent Trame
Partner
Los Angeles

John serves as a one-stop resource for employment counseling and litigation for companies across the country, particularly as they relate to California operations.

John serves as a one-stop resource for employment counseling and litigation...

John Viola
Associate
Chicago

Beth supports health care clients in a variety of transactional and regulatory matters.

Beth supports health care clients in a variety of transactional and regulat...

Elisabeth Volk
Partner
Dallas

Mackenzie is an experienced trial attorney who represents health care entities and other businesses and directors in high-stakes litigation matters.

Mackenzie is an experienced trial attorney who represents health care entit...

Mackenzie Wallace
Senior Counsel
St. Louis

In an era of escalating pension liabilities and sweeping health care reforms, Trish serves as an employee benefits advisor to public and privately-owned businesses and go...

In an era of escalating pension liabilities and sweeping health care reform...

Trish Winchell
Partner
Dallas

Dawn defends major product manufacturers and chemical distributors in products liability and mass tort litigation.

Dawn defends major product manufacturers and chemical distributors in produ...

Dawn Wright
Partner
St. Louis

As an experienced litigator in Missouri courts and beyond, Maria has worked for clients in the banking litigation and fiduciary litigation arenas.

As an experienced litigator in Missouri courts and beyond, Maria has w...

Maria Zschoche