Healthcare Litigation Support, L.L.C.
"We didn't
want just a physician. There is no one else who can do
what you do."
Healthcare Litigation Support, LLC is not a medical referral service, but rather a team of experienced healthcare experts who consult on litigation issues and testify as needed. In addition to the four Principals, there is a larger
medical expert witness group of Associates, individuals with specific expertise and areas of knowledge we include in order to fully serve the needs of the legal community. Our
group of Associates, many of whom we've worked with during our careers in healthcare, are men and women whose credentials, capacity and character are unquestioned. They meet the high standards we set for ourselves, and you can be assured that in the event one or more of our Associates are engaged to work on your case, you are getting the best expert available.
The following is a sample list of cases in which the experts at Healthcare Litigation Support have assisted in resolving healthcare and health insurance litigation. Below the following case list is a selected list of clients.
Plaintiff Cases:
1) A third party administrator (TPA) and a case management company were sued by the estate of an individual covered under a self-insured health policy, claiming that the deceased had suffered irremediable damage as a result of the health plan's delay in approval/coordination of stem-cell transplant benefits. We were asked to determine if there was deviance from industry standards and, if so, to what degree and were asked to review and comment on internal policy and procedures for both the TPA and the case management company. We assisted the attorneys in their development of both discovery requests and deposition issues.
2) A health insurance company was sued for misrepresentation and non-adherence to industry standards in its processing and payment of medical claims. We testified on both of those issues, and provided expert testimony on the marketing of the insurance product and the insurer's communications with the customers, both of which were material elements of this case.
3) A hospital CEO was terminated after he reported to the board of directors that the hospital's management company was possibly committing Medicare fraud. Subsequently, the former CEO was unable to find an equivalent position within the region's hospital community. We determined that the board of directors violated its own policies and procedures in the termination, and that they further released information that compromised the former CEO, and kept him from continuing in his career as a hospital administrator.
4) A physician who failed to satisfactorily complete his surgical training was credentialed by a hospital and subsequently performed specialized surgery in the very areas in which he failed to complete his training. the physician was subsequently sued for malpractice. We testified as to the adherence (or lack thereof) by the hospital's medical staff office and credentialing committee, using both its own and industry standards. We assisted the attorneys with the development of both discovery requests and deposition issues.
5) A health plan was sued because of a bad outcome birth. The bad outcome was due to a delay in performing a C-section. Plaintiff argued that the financial incentives and communications to physicians established an incentive not to do C-sections.
7) A health plan was sued under Federal False Claims Act by "whistleblower" for alleged misrepresentation on application(s) to obtain Medicare contract(s).
Defense Cases:
1) A health insurance company was sued for allegedly failing to properly handle and pay its portion of a claim that coordinated with Medicare. The insured was covered under a Medicare HMO. We testified as to the difference between Medicare Managed Care and "regular" Medicare and provided testimony on the applicability of state regulations and the National Association of Insurance Commissioner's (NAIC) standards.
2) A national accounting firm was sued by one of its hospital audit clients for malpractice. We testified on two separate but related issues. The first was the billing and collection activities of the hospital. The second was the performance of the board of directors in fulfilling its responsibility to monitor and assess organizational processes and outcomes.
3) A health plan was sued by one of its contracting provider organizations for failure to adhere to the terms of its contract. We testified on a number of issues, including the risk sharing model, termination provisions and claims processing. We researched and testified both on industry standards and on our own expert analysis of the facts.
4) A health plan was sued for wrongful death resulting from delay in receiving needed care during emergency. Plaintiffs argued that HMO's Medicare risk program did not clearly communicate that member could self-refer to ER for urgent care, thereby causing delay in needed care resulting in death.
5) A health plan was sued for delay of treatment and wrongful death of member. Plaintiffs argued that the health plan's surplus-sharing model to non-referral to specialists, which resulted in delay in treatment and death.
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