Healthcare

Our team is uniquely qualified to advise group health plans on cutting-edge, innovative ways to contain costs, save money, and address the outrageous abuses and conflicts that are rampant in healthcare today.

We are passionate about helping employees, employers, and fiduciaries identify and monitor their health care costs, and ensuring that money is not spent on hidden fees, erroneous charges, prohibited transactions, wasteful spending, fraud, and abusive billing practices. We also help self-funded plans receive the reductions and offsets that they are entitled to under federal and state laws and regulations, many of which are greatly underutilized. We also work with and advise plan service providers that share the desire to make healthcare a more transparent, affordable endeavor, and we are proud to work with pioneering companies, consultants, and experts who are dedicated to disrupting the status quo.

Summary of Services

Whether seeking assistance with healthcare issues related to plan design, vendor management, or compliance, clients can be confident in their Berger Montague healthcare team of attorneys and other professionals.

Compliance Review
For a fixed price or an hourly fee (client’s choice), we conduct internal confidential audits on behalf of plan sponsors for compliance with the Affordable Care Act, ERISA, HIPAA, The Consolidated Appropriations Act, No Surprises Act, and other applicable laws & regulations.

Plan Design
Review client’s existing plans and contracts and highlights areas of concern; designs health and welfare benefit programs to reduce the costs of coverage; and advise on third-party administrator services, stop-loss coverage, PBM selection, and more.

Vendor Management
We conduct internal confidential audits on behalf of plan sponsors for compliance with the Affordable Care Act, ERISA, HIPAA, The Consolidated Appropriations Act, No Surprises Act, and other applicable laws and regulations. We advise on all phases of regulatory and fiduciary compliance and assist with the preparation of filings to the proper agencies.

Training
We offer training modules on a wide variety of topics related to healthcare, including but not limited to 501(r) financial aid requests, The Consolidated Appropriations Act of 2021, Fiduciary Compliance, Getting Your Data, Exercising Your Duty to Monitor, and Health Plan 101. We also customize trainings to address client needs.

Benefits of working with Berger Montague

Expertise—A deep bench of healthcare attorneys, professional staff, and consultants without conflicts with a long record of success in dealing with the largest carriers, TPAs, and hospital systems in the country.

Passion for lowering costs—Dedicated to fixing the system and helping our clients reduce legal exposure and litigation risk while also lowering their healthcare costs through the provision of comprehensive and sophisticated counseling services.

Transparency—Our legal experience of federal and state laws and regulations governing healthcare allow fiduciaries to obtain their own claims data and have their eyes opened to the direct and indirect compensation their plan service providers often receive.

Experience—The depth and variety of experience among the lawyers in the BMPC Healthcare Benefits & Law Group is unmatched to any other, and provides a competitive edge to clients.

Our Mission

• Provide cost-effective counsel and advice to group health plan sponsors and service providers to help them meet their fiduciary obligations
• Help diligent plan sponsors obtain claims data and compensation information from third parties
• Reduce healthcare costs while implementing processes to ensure the same or better quality of care
• Reduce liability exposure and administrative fees through crafting of plan documents and monitoring
• Hold TPAs and plan service providers accountable and ensure they perform their duties without self-dealing or improper claims handling

About Berger Montague

The BMPC Healthcare & Benefits Law Group offers legal and consulting services to plan sponsors, fiduciaries, participants and service providers seeking innovative methods of cost containment through plan design and/or direct negotiation, seek access to data related to provider cost and quality, seek or are required to make compensation disclosures, or need help understanding and/or enforcing the provisions of ERISA and other laws and regulations governing group health plans.

Fed up with the state of healthcare in America, in 2021, Berger Montague formed a new consulting arm, called the BMPC Healthcare and Benefits Law Group with the single-minded mission of using its legal experience and resources to play a part in addressing the problems in healthcare, and the demand for the group has been off the charts.

All of our attorneys concentrate in diverse legal areas including Healthcare, Employee Benefits, ERISA, Insurance Litigation, Insurance Fraud, False Claims Act, Antitrust, and Consumer.