Led by Healthcare Practice Group attorneys Mohamed H. Nabulsi, Joseph M. Franck, and Todd M. Nosher, Mandelbaum Barrett PC secured an early and significant win in New Jersey federal court for a healthcare facility client. The litigation was brought by a major insurance company plaintiff for purported violations of the New Jersey Insurance Fraud Prevention Act in connection with the submission of claims using a UB-04 form for facility services.
Shortly after making their appearance in the case, the Mandelbaum Team scrutinized plaintiff’s claims and found numerous defects in both the pleading and plaintiff’s theory of the case. The team then moved quickly for dismissal of plaintiff’s causes of action, including purported claims for fraud and unjust enrichment, citing fatal defects in the complaint including plaintiff’s weak factual averments. The District of New Jersey agreed with the Mandelbaum Team and dismissed all claims against our client, pursuant to Rule 9(b) and Rule 12(b)(6). Although the court is allowing plaintiff another opportunity to plead its case, the court’s decision will make it difficult for plaintiff to sustain a claim under controlling law.
This marks a notable victory for Mandelbaum’s client—and its healthcare clients generally—as it can be cited by other healthcare practitioners facing similar challenges from insurance companies.
The proliferation of claims disputes in the healthcare industry has led to a new wave of aggressive litigation by insurance companies against healthcare providers. Given the high stakes involved, defeating or at least degrading these actions at the pleading stage is critical to enabling the healthcare provider to avoid costly and risky litigation by quickly disposing of baseless claims.
Mandelbaum Barrett PC’s Healthcare Practice Group has significant experience in handling complex healthcare litigation, including niche litigation against healthcare practitioners facing claim disputes by insurance companies.
The Mandelbaum team on this case is composed of Mohamed H. Nabulsi, Todd M. Nosher and Joseph Franck.
These stories are successful case results from our attorneys. Please note that results may vary depending on your particular facts and legal circumstances.