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Health Plans & Other Insurers

  • Advised a global health care company on a variety of issues in connection with its acquisition of several health plans and provider groups, including health care regulatory due diligence, health care regulatory advice regarding transaction structure and strategy, and preparation of regulatory notices and other filings.
  • Represented a large Medicare and Medicaid Advantage and Commercial Health Plan in connection with various federal regulatory matters, including a Medicare audit, and the determination of its star rating, which is the system used by the Centers for Medicare & Medicaid Services to rate Medicare managed care plans.
  • Regularly counsels a large health plan offering Medicare Advantage, Medicaid Managed Care, Commercial, and Managed Long Term Care products on various matters necessary to the growth of the health plan, including mergers and acquisitions, financings, Medicare audits and reporting, ACA benefits and compliance, investigations and executive compensation matters.
  • Advised a large Medicare and Medicaid Advantage and Commercial Health Plan who sold certain NJ Medicaid assets to a publicly traded managed care organization. Mintz Levin represented the seller plan and its affiliates in connection with the sale.
  • Represented a large Medicare and Medicaid Advantage and Commercial Health Plan in connection with its proposed acquisition of a Medicare Advantage plan. We represented the client in connection with all aspects of the transaction.
  • Advised an employee in negotiating the terms of employment as Executive Vice President, Medical Affairs for a major health insurer.
  • Represented a community-based not-for-profit managed care organization in connection with the transfer of its membership interest in a plan serving over 300,000 enrollees to another not-for-profit health insurer serving more than 613,000 enrollees in the states of New York, Vermont, and New Hampshire.
  • Represent a publicly traded managed care company with ongoing health regulatory and contracting advice.
  • Successfully negotiated a settlement for our client, Medical Acquisition Company, a lien management and medical funding company specializing in third-party liability tort cases, in a class action alleging TCPA violations.
Case Study
Mintz has represented multiple health plans seeking to contract with the Centers for Medicare & Medicaid Services (CMS) to offer Medicare Advantage Plans, Part D Plans, or both. Mintz attorneys assist health plans with the CMS application process, notices of deficiencies, and application denials.
Case Study
Mintz has worked with both Medicare Advantage Organizations and Part D plan sponsors across the United States to assist them in offering MA-PD and Part D EGWPs. Mintz attorneys help these clients submit applications to CMS, ensure compliance with CMS guidelines, and resolve ERISA issues.