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Nossaman LLP

Healthcare

Managed Care

"Managed care" is the predominant mode of delivery of healthcare services in California today. Nossaman attorneys have participated for many years in the development, refinement and application of the mechanisms of managed care, beginning with the authorship of the landmark Knox-Keene Health Care Service Plan Act of 1975 by our senior partner John T. Knox.

We represent health plans in the private and public sectors, very large and very small, full service and specialized, dental, eye care, and mental, from initial licensure through growth, maturity and acquisitions. Our counsel and representation ranges the full spectrum, from their internal and complex external contractual needs to their demanding regulatory relationships. We have represented unique managed care entities such as "limited" plans and workers' compensation healthcare organizations. And Nossaman attorneys successfully counseled, structured and shepherded the first "discount fee plan" licensed by the State of California.

We also represent other players in managed care, including large healthcare delivery systems, as well as the innovative "small group" multi-plan exchange CaliforniaChoice, which we helped to create and is now the largest of its kind in the country. We represent hospitals, medical groups, IPAs, PPOs, laboratories, outpatient clinics and surgicenters and other core providers of managed care in California.

Our services extend beyond the traditional legal and regulatory to legislative representation and advocacy, a virtually unique resource for our clients. Our attorneys also win millions of dollars for our clients in public reimbursement claims.

Our managed care services draw on the expertise of both our Healthcare Practice Group and of other departments of the firm, including employment, real property, tax, corporate, litigation and government relations.

The breadth of our managed care client roster, from plans and delivery systems to their contracting providers and institutions, together with the sophisticated skill set that has been honed over years of practice, have instilled in our attorneys a deep understanding of both the legal environment and also of the challenging business dynamics of the managed delivery of healthcare in California. An accolade that we are pleased regularly to receive is that our counsel is eminently practical.

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