Health plan and insurer litigation
Provider disputes, contract claims, ERISA and bad-faith actions, administrative hearings, government investigations, and member litigation.
Managed care · Payor-provider · Insurer disputes
Healthcare litigation with commercial judgment.
Healthcare remains a core strength of The Zorkin Firm. The firm represents managed care plans, insurers, and business clients in provider disputes, contract disputes, reimbursement matters, regulatory issues, administrative proceedings, and related civil litigation.
Core capabilities
Subject-matter fluency for complex managed care and payment disputes.
The firm brings commercial litigation strategy to disputes involving managed care, insurance, provider relationships, reimbursement, regulatory obligations, and healthcare business risk.
Payor-provider and reimbursement disputes
Out-of-network providers, payment methodologies, emergency services, hospitals, ambulatory surgical centers, specialty practices, pharmacies, and air ambulance claims.
Healthcare laws and regulations
Managed care issues involving the Knox-Keene Act, California Insurance Code, ERISA, FEHBA, HIPAA, Medicare Act, and No Surprises Act.
Selected experience
Trial, arbitration, dispositive motions, and negotiated resolution.
Representative matters include a unanimous jury verdict, defense arbitration awards, summary judgment, demurrers without leave to amend, and negotiated dismissals or settlements in healthcare payment and member disputes.
Out-of-network neurosurgery dispute
Obtained a unanimous defense verdict for a major California health plan and established that the provider was properly paid.
Pharmacy underpayment claims
Obtained summary judgment on contract and fraud claims seeking $40 million in alleged underpayments.
Hospital payment disputes
Obtained defense judgments for major California health plans in hospital-system and Los Angeles hospital arbitrations.
Air ambulance claims
Obtained an order sustaining a demurrer without leave to amend on federal preemption grounds.
Prior results do not guarantee or predict a similar outcome in any future matter.
Supporting resource
No Surprises Act and Federal IDR.
The No Surprises Act remains relevant to certain healthcare payment disputes, but it is one component of the firm’s broader healthcare litigation practice.
No Surprises Act resourceCommercial perspective
Healthcare matters may involve overlapping contract, fraud, statutory, administrative, preemption, reimbursement, and business issues. The firm’s broader commercial litigation practice supports a unified strategy.
Commercial litigation overviewDirect answers
Frequently asked questions.
These answers are general information, not legal advice. The analysis of a specific matter depends on its facts, law, forum, and objectives.
What healthcare litigation does The Zorkin Firm handle?
The firm handles managed care, health plan, insurer, provider, reimbursement, contract, ERISA, bad-faith, administrative, regulatory, and related civil disputes.
Does the firm handle out-of-network provider disputes?
Yes. The firm has handled matters involving out-of-network neurosurgery practices, orthopedic surgeons, pharmacies, hospitals, ambulatory surgical centers, emergency services, and air ambulance providers.
What healthcare laws are relevant to the firm’s practice?
Depending on the matter, relevant law may include the Knox-Keene Act, California Insurance Code, ERISA, FEHBA, HIPAA, Medicare Act, No Surprises Act, contract law, preemption principles, and procedural rules.
Does the firm handle No Surprises Act matters?
Yes. The No Surprises Act remains part of the firm’s healthcare and reimbursement experience. The website maintains a separate resource page for federal IDR and related payment-dispute issues.
Contact The Zorkin Firm
Does the dispute require senior litigation judgment?
Contact the firm to discuss the parties, general nature of the matter, business objective, and next step. Do not send confidential information before an engagement is confirmed.