For over fifteen years, Katherine has represented managed care companies in business and health care disputes, as well as group insurers, employers and third-party administrators in disputes involving health, disability, life and AD&D benefits, including ERISA and insurance bad faith claims.
As part of her managed care practice, Katherine routinely handles business-practices and provider-prompt-pay disputes in court and arbitration proceedings. These matters often involve claims arising out of managed care agreements, third-party administrative services contracts, out-of-network reimbursement or claims handling practices, verification of coverage or benefits, and plan coverage provisions. In handling these disputes, Katherine defends claims based on alleged ERISA violations, breach of contract, quantum meruit, breach of fiduciary, insurance code violations, fraud, misrepresentation and other torts. Katherine has developed the claims data management skills necessary to litigate the hundreds or thousands of medical claims often at issue in managed care cases, and has worked with a variety of experts on medical coding and billing issues. Relatedly, Katherine has handled overpayment and fraudulent billing practices claims brought by third-party payers against health care providers.
As part of her employee/group-insurance benefits practice, Katherine is experienced in ERISA benefits litigation, including standard-of-review, preemption, standing, and discovery issues in those cases. In addition to ERISA, Katherine is familiar with related regulatory schemes, such as the ACA and COBRA, and has significant experience in state group insurance regulations.
Katherine has also represented health insurers and other clients in suits involving medical negligence and personal injury claims under theories of direct and vicarious liability.
In addition to her trial court practice, Katherine represents clients in federal and state courts of appeal. She has presented oral argument in the United States Court of Appeals for the Fifth Circuit, and Texas Courts of Appeal. The issues in these appeals have included jurisdictional challenges, successor and contractual liability, and ERISA standard-of-review and benefits-decision defenses.
Katherine’s representative experience includes: