Boutin Jones Inc. served as counsel for a medical group in a dispute with an insurance company over the rates the group was entitled to be paid for cutting-edge medical services provided to the insured patients. The firm’s trial team prevailed by obtaining an arbitration award establishing the rate for services at the rate sought by the medical group. Shareholders Steve Boutin and Michael Chase were the primary Boutin Jones attorneys on this matter.
We have also served as counsel for a medical group in a dispute with a capitated health plan over the method of computing the capitated payments owed to the group under the parties’ agreement. The dispute arose after the passage of the federal Deficit Reduction Act of 2005 and the subsequent publication by Centers for Medicare and Medicaid Services (CMS) of Outpatient Prospective Payment System Relative Value Units (OPPS RVUs). The firm achieved a favorable settlement during the arbitration hearing which resulted in higher compensation to the group on a going-forward basis. Shareholders Michael Chase and Bob Swanson were the primary Boutin Jones attorneys on this matter.
Boutin Jones served as counsel for a medical group in a dispute with a capitated health plan over breaches of the group’s exclusivity rights. The firm’s trial team prevailed in arbitration proving that the parties’ contract entitled the group to add services which constituted “technical advances,” and recovered in excess of $250,000 in damages and attorney’s fees for the medical group. Shareholder Steve Boutin was the primary Boutin Jones attorney on this matter.