Emily Davis blends legal experience and a solid foundation in the business of healthcare with a recognized ability to manage healthcare litigation and guide clients through the complex regulatory issues relating to reimbursement. She has represented major California health plans and other third party payers in arbitrated and litigated matters involving hospital and other provider claims for payment. In addition to her work on payer-provider issues, Emily supports the firm’s comprehensive litigation practice, bringing litigation strengths and a life-long interest in healthcare to this dynamic area of law.
Emily’s initial focus on healthcare provider disputes for major California health insurers gives her a big picture understanding of reimbursement and claims processing issues from both the health plan and healthcare provider perspective. Emily’s experience encompasses breach of contract, coverage, and coordination of benefits issues, along with medical necessity cases and related matters. She has handled disputes involving insurance coverage, coordination of benefits, other payers, disallowed charges, fee schedules, claims timeliness, experimental/investigational matters, pre-existing conditions, EOC exclusions, contract interpretation, misrepresentation, and recission. In a recent multi-million dollar healthcare claim case involving a contract issue, Emily helped negotiate a settlement and strategized with the health plan to revise their contract in order to avoid a recurrence of the problem.
In her current role, Emily leverages deep regulatory expertise, business understanding, and focus on and healthcare litigation to represent healthcare providers and other clients in managed care and other reimbursement litigation. She has handled numerous matters through various stages of litigation and served as second chair in arbitration hearings. Her purview includes federal and state healthcare fraud and False Claims Act matters, and regulatory compliance matters. Emily’s comprehensive knowledge of Covered California and other large California health plans helps healthcare providers navigate the complexities of the state’s consumer-driven healthcare industry as well as state and federal regulatory frameworks.
- Defended against multiple large provider dispute actions.
- Obtained an award of attorneys’ fees for a healthcare service plan in a provider dispute matter.
- Drafted a successful motion for summary judgment and summary adjudication.
- Drafted influencer marketing agreements and related restricted stock unit agreements for a prominent YouTube star (>7 million subscribers).
- Managed the application preparation to Covered California for a health plan to participate in the California Health Insurance Exchange.
- Drafted research on the development of mental health law in California to be used throughout the Court’s mental health department.
- Assisted Judge Gerald Johnston with probate, mental health, and elder abuse matters.
July 9, 2021
July 9, 2021