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Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

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Healthcare Private Equity Compliance Checklist

The complex and ever-changing healthcare regulatory and enforcement environment, including increased focus on the role of private equity firms in their portfolio companies, make compliance a top priority for private equity firms investing in healthcare companies. The best way to limit your exposure as a private equity firm is to avoid a compliance misstep in the first place. Additionally, an effective and robust compliance program for your portfolio healthcare company makes it much more attractive to potential buyers and helps you avoid an unexpected and costly investigation or valuation hit down the road. Download the Healthcare Private Equity Compliance Checklist to assess whether your portfolio company's compliance program is up-to-date.

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David A. King

Member

Nashville
(615) 742-7890 TEL
(615) 742-2815 FAX

David A. King

Member

Nashville
(615) 742-7890 TEL
(615) 742-2815 FAX
Nashville
(615) 742-7890 TEL
(615) 742-2815 FAX

David King is the leader of the firm's Managed Care Strategy & Disputes Group.  He regularly serves as lead counsel in managed care matters and other healthcare disputes on a national basis for several of the largest healthcare providers in the country. These providers include for-profit and non-profit hospital systems, ambulatory surgery companies, air ambulance services, specialty providers, physician groups and ancillary service providers.  David brings to these matters nearly thirty years of experience as a healthcare and trial attorney, as well as his skill in creating and applying straightforward, timely, and cost-effective solutions to complex problems.  His focus on managed care issues includes:

  • Managed Care Disputes – David regularly represents healthcare providers in disputes with managed care companies  around the country. These disputes include but are not limited to underpayments, medical necessity denials, attempted recoupments and offsets, contract interpretation, refusal to contract, discrimination and retaliation against out-of-network providers and related reimbursement disputes, and related legal issues involving the Affordable Care Act, ERISA preemption, UCR laws, prompt pay laws, any willing provider laws, and laws regarding payor audits, recoupments, and offsets. David has many years of experience and success implementing all forms of resolution for these disputes, including negotiation, mediation, arbitration and litigation.
  • Managed Care Strategy and Contracting – David consults with various healthcare providers on payor network and out-of-network strategies, communication plans, and other issues involving the relationships among providers, insurers, self-funded plans, benefit administrators, and vendors. He also participates in drafting and negotiating contracts, as well as creating and implementing out-of-network reimbursement strategies and agreements.

David King is the leader of the firm's Managed Care Strategy & Disputes Group.  He regularly serves as lead counsel in managed care matters and other healthcare disputes on a national basis for several of the largest healthcare providers in the country. These providers include for-profit and non-profit hospital systems, ambulatory surgery companies, air ambulance services, specialty providers, physician groups and ancillary service providers.  David brings to these matters nearly thirty years of experience as a healthcare and trial attorney, as well as his skill in creating and applying straightforward, timely, and cost-effective solutions to complex problems.  His focus on managed care issues includes:

  • Managed Care Disputes – David regularly represents healthcare providers in disputes with managed care companies around the country. These disputes include but are not limited to underpayments, medical necessity denials, attempted recoupments and offsets, contract interpretation, refusal to contract, discrimination and retaliation against out-of-network providers and related reimbursement disputes, and related legal issues involving the Affordable Care Act, ERISA preemption, UCR laws, prompt pay laws, any willing provider laws, and laws regarding payor audits, recoupments, and offsets. David has many years of experience and success implementing all forms of resolution for these disputes, including negotiation, mediation, arbitration and litigation.
  • Managed Care Strategy and Contracting – David consults with various healthcare providers on payor network and out-of-network strategies, communication plans, and other issues involving the relationships among providers, insurers, self-funded plans, benefit administrators, and vendors. He also participates in drafting and negotiating contracts, as well as creating and implementing out-of-network reimbursement strategies and agreements.

David currently represents healthcare providers against nearly all of the major managed care companies in the country including several BlueCross BlueShield licensed entities, United Healthcare, Cigna, Aetna, and several self-funded plans and third party administrators. David's successes have led to national recognition for many years by the Best Lawyers in America, Super Lawyers, and other publications.

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Memberships

American Bar Association — Health Law Section

American Health Lawyers Association (AHLA)

Tennessee Bar Association — Health Law Section

Nashville Healthcare Council

Nashville Council of Healthcare Attorneys

News

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Representative Experience

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Publications

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Past Events

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Media Mentions

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Accolades

BTI Client Service All Star Team for Law Firms (2017)

Best Lawyers in America® — Commercial Litigation; Health Care Law; Insurance Law; Litigation: Health Care; Litigation: Insurance; Litigation: Securities; Medical Malpractice Law: Defendants; Personal Injury Litigation: Defendants (2003-2018)

Best Lawyers in America® — Nashville Litigation: Health Care "Lawyer of the Year" (2018)

Mid-South Super Lawyers (2006-2009, 2011-2017)

Nashville Post "The Best Lawyers in Nashville" (2011)

Firm Leadership:

Managed Care Strategy & Disputes Group — Leader (2010-present)

Products, Torts & Insurance Team — Leader (2012)

The Network of Trial Law Firms, Inc. — Firm Representative (2009-2016)

Retirement Plan Investment Committee — Chair (2007-2016)

Executive Committee (2008-2011)

Community Leadership:

Hillwood Country Club — President (2010); Board of Directors (2008-2011, 2001-2003)

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