With the vast changes taking place in our healthcare landscape, it is becoming clear that the powerful managed care systems sometimes achieve their success at the cost of the physician or the patients. Zimmerman Reed currently represents a group of physicians, challenging the conduct of health-maintenance organizations ("HMO"), preferred provider organizations ("PPO") and claims administrators in reimbursing participating physicians. The lawsuits allege that the HMO's, PPO's and claims administrators intentionally manipulate reimbursement rates of participating physicians.
In addition, our firm is investigating claims of patients who allege that the managed-care plans they purchased are worth less than what was promised due to hidden measures the HMO's employ to restrict access to medical care and deny treatment.
Zimmerman Reed is also challenging the conduct of Prescription Benefits Management Companies (PBM's) in litigation filed by employees who pay PBM's. The lawsuits allege that PBM's fraudulently withhold money from employees' ERISA Health Benefits Plan resulting in higher premiums, co-pays and costs for the employees. These claims are not against the employer; rather, they seek to change the conduct of PBMs and pharmacies. We are actively pursuing these cases and are interested in consulting with consumers whose employer's work with PBMs.
Some of our healthcare litigation cases include:
|
