The Uses of Arbitration / Judicial Reference in Complex Health Care Litigation -

Everyone knows that using a mediator with health care experience is valuable in complex health care matters. But there are many other ways ADR can assist both counsel and parties in complex health care litigation.

More and more service contracts between health care providers and insurers and/or payors call for binding arbitration. The advantages arbitration gives the parties are time savings, the ability to choose a decision-maker with health care experience, the ability to contain discovery to that which is necessary for resolution of the dispute and the ability to streamline the resolution process (such as by addressing issues in phases, or “buckets.” For example, Phase I could resolve “medical necessity” claims; Phase II, the “other payor” claims, etc.). Similar advantages apply to other health care disputes, such as the sale of health care practices or facilities, medical partnership disputes and billing issues. Choosing an arbitrator with health care experience means counsel does not need educate the decision-maker as to Medicare reimbursement, dual use of a license during the sale of a facility or other issues unique to health care. In matters where there is no arbitration clause, the parties should consider agreeing to arbitration post-dispute to utilize its unique advantages.