HEALTH CARE
LITIGATION
Our Clients
We represent providers, pharmaceutical and medical
device companies, health plans, insurers, private equity
firms, lenders and other industry participants in all types
of litigation relating to the delivery of and payment for
health care services.
RECOGNIZED BY
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Chambers USA
o Healthcare (Illinois, New York) 2015, 2014
U.S. News – Best Lawyers® “Best Law Firms”
o Health Care Law (National, Chicago, New
York) 2016, 2015
Our Services
Attorneys in the Health Care Litigation practice work
closely with the firm's transactional health care attorneys
and others to provide a full range of health care litigation,
investigative, regulatory and transactional services.
We represent clients in all types of health care-related
litigation involving hospitals, provider groups, members
of national health and dental benefits associations,
provider networks, pharmaceutical suppliers, health data
analytics firms, and others involved in the delivery of
health care and related services. We have extensive
experience defending against qui tam and False Claims
Act cases. We handle litigation relating to the purchase
and sale of hospitals and other health care assets,
including regulatory actions and matters relating to
health care information privacy, health care facility
expansion and construction projects, the revocation of
charitable property tax exemptions, reimbursement
rates, the termination of participation agreements,
payment for emergency and out-of-network services,
and referrals to in and out-of-network surgery centers.
Working in conjunction with our health care transactional
and regulatory colleagues, we handle antitrust claims,
including claims arising from collaboration between
health care providers and the integration of various
health care services, as well as Racketeer Influenced
and Corrupt Organizations Act (RICO) claims.
Katten attorneys also have extensive experience with
litigation involving physician compensation agreements,
anti-kickback and Stark cases, physician employment
actions, and ERISA matters.
Our pharmaceutical work includes pay-for-delay and
related antitrust cases, matters relating to the publication
of clinical, reimbursement and marketing information
about pharmaceutical products, pharmaceutical products
liability and actions based on failure to warn, and
misfiled prescriptions.
Our litigators work closely with our
patent lawyers litigating various aspects of
pharmaceutical patent challenges, primarily in the
generic market.
By combining cutting-edge litigation practices with deep
experience in health care, Katten's Health Care
Litigation team helps clients achieve business-savvy,
cost-effective and sustainable results.
. “This group is very knowledgeable.”
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Chambers USA 2013
(Healthcare)
services in teaching hospitals, school-based health
care services, early intervention services and
personal care services in violation of applicable
requirements.
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Provision of advice to clients regarding physician
compensation agreements, anti-kickback and Stark
cases, including cases arising under the False
Claims Act.
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Guidance to hospital client in cases alleging
violations of state and local public accommodations
laws.
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Representation of clients in disputes between
hospitals and exclusive provider groups.
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Defense of clients in pharmaceutical products
liability and negligence actions in connection with
failure to warn and mis-filled prescription claims.
Our Experience
False Claims Act
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Provision of advice to a hospital management firm in
settlement of allegations that it breached the False
Claims Act by aiding the inappropriate admissions of
patients for hospital services. Katten's client did not
admit any wrongdoing and is one of several
defendants in New York federal litigation dating back
to 2002.
Successful defense of the New York City
Department of Education against an alleged False
Claims Act violation regarding the submittal of
Medicaid claims. The US District Court for the
Southern District of New York dismissed the case,
holding that Medicaid providers (such as school
districts that provide health services) cannot be
found to have violated the False Claims Act when
they followed state guidance in submitting their
Medicaid claims, even if that guidance is
inconsistent with federal Medicaid law.
Counsel to a large municipal school district in
obtaining dismissal of a qui tam case alleging
violations of the False Claims Act in connection with
the school district's Medicaid claims for case
management services. The case is on appeal before
the US Court of Appeals for the Second Circuit.
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Counsel to clients in False Claims Act cases
involving allegations of duplicate billing, billing for
medically unnecessary services, billing for services
by unlicensed providers, violations of the Stark Act
and anti-kickback statute, and billing for physician
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Defense of a major teaching hospital against a class
action suit alleging violations of various statutes in
connection with the hospital's billing and collection
practices.
The suit alleged liability of approximately
$20 million. By limiting the scope of the suit through
discovery, statutes of limitations and class
certification arguments, and the resulting restrictive
court rulings, Katten achieved a highly successful
settlement of the litigation.
Reimbursement
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Representation of a large municipal health system in
a suit filed against the federal Medicare agency
alleging an illegal and arbitrary cap on
reimbursement cost apportionment.
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Representation of a national wellness provider in a
dispute with a major commercial insurer regarding
billing, coding and the right to reimbursement for
procedures performed in connection with insured
and self-funded/Administrative Services Only (ASO)
coverage. Katten settled the dispute and achieved a
result which paved the way for the wellness provider
to continue providing the services and receiving
reimbursements from the insurer.
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Successful representation of a wellness provider in a
dispute with a major national insurer regarding the
right to reimbursement for procedures performed in
connection with risk and ASO coverage.
Katten
achieved a result which paved the way for the
Representation of a large, academic medical center
against a False Claims Act lawsuit alleging violations
of the Medicare teaching physician rules and other
Medicare rules. The complaint sought tens of
millions of dollars in damages. Katten successfully
obtained dismissal by the federal district court and
ultimately achieved an extremely favorable
settlement of all claims against our client.
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Class Action
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wellness provider to continue serving clients and
receiving reimbursement from the insurer.
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Provision of advice to clients regarding cases
challenging Medicare and Medicaid reimbursement
limitations, restrictions and recoupments.
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Counsel to national prescription company in its
successful appeal in the Illinois Appellate Court
against an attempt by the State of Illinois to access
confidential information that had been reported to
the company's component PSO. In a case of first
impression, the trial court dismissed the state's
lawsuit, upholding the patient safety organization
protections promulgated under PSQIA. In the first
appellate court ruling in the country, the court
affirmed the trial court's dismissal.
Defense of hospital clients in Medicare appeals
before the Department of Health and Human
Services Provider Reimbursement Review Board in
cases involving issues such as cost report audit
adjustments, graduate medical education and
indirect medical education payments, reimbursement
for physician services, bad debt reimbursement, and
disproportionate share hospital (DSH) payments.
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Preparation of amicus brief on behalf of major
university health consortium's PSO before the
Kentucky Supreme Court on a direct appeal
involving a ruling by the appellate court that quality
and peer review materials prepared by hospitals
were not privileged and confidential under the
federal Patient Safety Act. Ruling conflicts with the
other reported decisions.
This will be the first state
supreme court to rule on the Patient Safety Act.
Others participating in our amicus brief include over
20 PSOs from around the country as well as the
American Medical Association, The Joint
Commission and possibly the American Hospital
Association.
Counsel to clients in a case involving alleged
violations of Medicare payment to bank rules.
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Representation of clients in disputes relating to the
publication of clinical, reimbursement and marketing
information about pharmaceutical products.
Patient Safety Organization
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Successful defense of Walgreens against a
subpoena issued by the State of Illinois seeking the
production of incident reports that had been
submitted to a component Patient Safety
Organization (PSO) created by Walgreens pursuant
to the Patient Safety and Quality Improvement Act of
2005 (PSQIA). When Walgreens refused to produce
the reports, Katten served as PSO consultant to
litigation counsel and authored an amicus brief filed
on behalf of 20 PSOs and health care trade
associations supporting Walgreens. The decision
dismissing the State's lawsuit against Walgreens
was affirmed on appeal, and this was the first state
appellate court case in the country to interpret and
apply the provisions of the PSQIA which render
qualified information non-discoverable and nonadmissible in state and federal court proceedings.
Author of amicus briefs filed on behalf of 30 PSOs
and health care trade associations before the
Kentucky Court of Appeals and the Supreme Court
of Kentucky regarding the protection of patient
safety work product in a medical malpractice action.
Following a split decision of the Kentucky Supreme
Court which allowed the trial court's order compelling
disclosure to stand, Katten is participating in an
amicus brief to be filed with the US Supreme Court.
Peer Review
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Successful defense of a major Chicago-area
hospital in a suit brought by a provider whose
privileges were revoked following peer review, a fair
hearing and board action.
Katten obtained an order
from the trial court dissolving a temporary restraining
order, thus permitting the hospital to revoke the
provider's privileges, and successfully defended an
emergency appeal filed on the eve of the termination
and the submission of a report to the National
Practitioner Data Bank.
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Defense of a major Chicago-area hospital in a suit
for tortious interference and related claims brought
by a provider whose privileges were terminated
following peer review. Achieved a final dismissal
from the trial court, successfully defended all
appeals and obtained an order for sanctions.
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Representation of clients in more than 250 peer
review fair hearings.
Defamation
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Representation of a hospital, its CEO and hospital
employees in a defamation and breach of contract
. lawsuit filed by a radiation oncologist whose
exclusive contract was not renewed. The
defendants' motion to dismiss was granted and
affirmed on appeal, based in part on Katten's
argument that the hospital's response to a third
party's inquiry about the quality of plaintiff's services
was a protected peer review communication and
therefore not subject to discovery or admissibility
into evidence.
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Antitrust
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Counsel to a hospital, department chair and senior
management in a state antitrust lawsuit filed by three
retinal surgeons whose request for medical staff
membership and clinical privileges was denied
based on the hospital's position that there was no
demonstrated need for these specialists. The suit
was dismissed based on the "rule of non-review" as
well as the plaintiffs' failure to demonstrate injury to
competition in the relevant geographic and product
markets.
Representation of clients in connection with claims
alleging anti-competitive collaboration among health
care providers in violation of the antitrust laws.
Representation of one of the world's largest
pharmaceutical companies in a pay-for-delay case.
RICO
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Representation of clients in claims against thirdparty administrators for alleged breach of contract,
fraud and RICO violations.
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Defense of clients in RICO and other claims arising
in connection with the lease of health care provider
networks.
Employment
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Provision of advice to clients regarding ERISA
fiduciary duty claims and non-ERISA benefit claims.
Representation of clients in physician employment
actions, including covenants not to compete,
wrongful termination and claims relating to Title VII,
the Retaliatory Employment Discrimination Act
(REDA), the Age Discrimination in Employment Act
of 1967 (ADEA), the Family and Medical Leave Act
(FMLA), the Office of Federal Contract Compliance
Programs (OFCCP), the Worker Adjustment and
Retraining Notification Act (WARN), the
Consolidated Omnibus Budget Reconciliation Act of
1985 (COBRA), and the Health Insurance Portability
and Accountability Act (HIPAA), among others.
Dispute Resolution
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Counsel to clients in connection with patent,
trademark, copyright and other intellectual property
matters arising in the health care industry.
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Representation of clients in disputes among
members of national health and dental benefits
associations.
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Advice to clients regarding disputes between
provider networks and pharmaceutical suppliers.
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Advocate for client in connection with the revocation
of charitable property tax exemptions for health care
entities.
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Provision of guidance to clients in disputes relating
to the denial of insurance benefits.
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Counsel to client in connection with refusal by the
government to adjust hospital cost reports to
account for collective bargaining costs, incremental
working capital interest expenses and pension costs.
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Representation of clients in regulatory matters
relating to health care facility expansion and
construction projects.
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