Health Care Litigation

Cooley has been on the forefront of representing health care clients in complex commercial and class action litigation and regulatory matters throughout the United States. Cooley lawyers have achieved groundbreaking victories on behalf of managed care companies in both the United States Supreme Court and California Supreme Court.

Key Facts

  • Extensive experience in defending managed care organizations in challenges to managed care practices ranging from provider to member disputes.
  • Significant expertise in efficiently and successfully handling rescission cases and other high profile cases involving denial of benefits and bad faith claims.
  • Sophisticated ERISA litigation team with nationally recognized expertise in employee benefits law.
  • Extensive experience in Antitrust, False Claims Act, RICO, HIPAA and privacy issues and regulatory issues.
  • Team includes former employees of the United States Department of Justice (including many former federal prosecutors) with significant experience in both high stakes litigation and conducting internal investigations.

Significant Results 

  • Served as lead counsel to PacifiCare Health Systems, Inc., in a nationwide class action brought by subscribers and physicians against the nation's largest managed care companies and obtained a unanimous ruling by the U.S. Supreme Court, on the issue of whether a prohibition of punitive damages rendered the arbitration clause invalid. Achieved a unanimous ruling by The Supreme Court in favor of PacifiCare, holding that the claims should have been sent to arbitration and went on to achieve a complete victory on the remaining non-arbitral claims on behalf of the client.
  • Represented a health plan in a consumer class action where plaintiffs alleged PacifiCare engaged in fraud through its reimbursement practices and sought relief "for the public benefit." In a decision that has had a direct and favorable impact on managed care organizations, the California Supreme Court overturned the lower court's denial of health plan's motion to compel arbitration and held that all claims for monetary relief, including those under unfair competition laws, can be arbitrated.
  • Secured a complete arbitration victory on behalf of a health plan in a lawsuit brought by a former insured who accused the health plan of engaging in illegal "post claims underwriting."
  • Successfully defeated class certification in a case challenging the marketing, advertising and premium rating process used to determine renewal premium rates for individual health insurance polices.
  • Secured an arbitration victory for a hospital system sued by an international software company based on the alleged misuse of risk management software.

Related Practices

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