Healthcare Litigation Expert Services

Healthcare Litigation Expert Services

In healthcare, in addition to Personal Injury and Certificate of Need work, we have participated in cases on behalf of hospitals, physicians, nursing homes, insurance carriers, and government agencies to address a wide range of healthcare liability and damage issues.

Examples of RPC’s work in healthcare forensic services include the following:

  • Presentation of analytical findings and conclusions in expert testimony, reports, affidavits, and exhibits
  • Assistance to legal counsel in preparing document requests, interrogatories and deposition questions
  • Attendance at depositions and evaluation of witness responses
  • Review of all materials provided by the opposing side, including any reports and supporting analytical findings prepared by the opposition's experts
  • Evaluation of settlement proposals

RPC has assisted health law attorneys, hospitals, nursing homes, home health agencies, physician practices, government agencies, and other healthcare organizations in legal proceedings nationwide. Our areas of expertise include health planning, health finance and market research. Examples of RPC’s healthcare consulting and forensic services include:

  • Medical Staff Issues
  • Payment Disputes
  • Fraud and Abuse
  • Medical Records Review
  • Property Casualty
  • Hospital and Related Healthcare
    Institution Liability Issues
  • Construction Litigation
  • Contract Disputes
  • Patient Rights
  • Antitrust Matters
  • Physician Liability Issues

Many of these studies have formed the basis for expert witness testimony before courts, administrative agencies and legislative committees. Dr. Ronald Luke has testified in federal and state courts on healthcare matters including antitrust, billing fraud and abuse, medical staff credentialing and physician contracts. In the course of providing this testimony, Dr. Luke has been accepted as an expert witness in demography, economics, statistics, market research, socio-economic impact analysis, health planning, land use planning and financial analysis.

Following are some examples of the types of cases on which RPC has consulted:

  • Determined the interest payments owed healthcare providers by an insurance carrier under rules of the Texas Workers’ Compensation Commission.
  • Established product and geographic market definition and demonstrated the defendant had market power that it was using to compel managed care plans to exclude a hospital from provider networks in a state anti-trust action.
  • Established product and geographic market definition and demonstrated the defendant had market power to force employers to exclude a healthcare provider from their provider networks in a federal antitrust action.
  • Determined the damages to a physician group due to a hospital's breach of contract and fiduciary duties regarding a managed care joint venture.
  • Determined the damages to physicians from loss of hospital privileges or closure of hospital-based programs.
  • Determined the damages suffered by a psychiatric practice group due to unlawful conversion of a long-term psychiatric hospital to short-term programs.
  • Assessed the damages to a neurosurgeon's income caused by a hospital management company's failure to fulfill its recruitment agreement.
  • Evaluated the damages to a household from the loss of health insurance due to inappropriate business practices of an insurance company in managing risk pools.
  • Determined the relevant market areas, market size and market shares for cardiology and cardiovascular surgery services for a defendant hospital in antitrust litigation regarding medical staff privileges.
  • Analyzed discrimination in payment of charges, the market area and the availability of competing hospitals for defendant insurance companies and hospital in antitrust litigation.
  • Determined the damages to third-party payors from improper billing practices of a revenue enhancement firm for the Texas Attorney General's Office.
  • Determined the damages to a hospital from the breach of a non-competition agreement by the purchaser of a long-term psychiatric hospital.

Payment Disputes

Payment disputes frequently arise between healthcare providers and health insurance plans. Some disputes are covered by contracts between the parties. Others are governed by state laws. Others arise because of the lack of any black-letter law determi… Read More

Medical Staff Disputes

A variety of situations can give rise to disputes between hospitals and physicians or between individual physicians and physician practices. Physicians may protest denial or loss of medical staff privileges, or what they see as interference with thei… Read More

Health Facility Construction Disputes

Hospitals and other health facilities are usually more complex to construct than other buildings of similar size. They must meet more stringent local, state and federal standards. Their air handling, plumbing and electrical systems are far more compl… Read More

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