For more than two decades, Jim Poth has assisted hospitals, health systems, laboratories, and other health care providers in implementing and executing strategies to ensure they receive appropriate reimbursement. His practice has focused on representing health care providers in litigation, arbitration, and negotiations with all types of payors. He has been the lead trial lawyer in dozens of cases for health care providers seeking to collect payment from both commercial and government-sponsored payors. He also has extensive experience in assisting health care providers in contract negotiations and providing advice on utilizing state and federal regulatory requirements to improve contract terms and providers' revenue cycle.
Recent matters Jim has handled include litigation for Cedars-Sinai Medical Center, Dignity Health (now CommonSpirit Health), and Prime Healthcare in challenging inappropriately low reimbursement paid by health plans for out-of-network services based on "reasonable and customary" calculations. He also has represented these same providers in disputing payments made under governing contracts. These cases follow his representation of providers asserting claims of statutory violations and fraud against health plans. He also has represented hospitals in qui tam litigation and disputes involving Medicare Secondary Payor issues, claims regarding fair debt collection practices, and balance billing issues.
Jim is a member of the American Health Lawyers Association (AHLA) and the Healthcare Financial Management Association (HFMA). He has spoken on managed care litigation, collection strategies, and medical records for these organizations.
U.S. District Court Issues Ruling on Preliminary Motion to Dismiss Interpreting 60-Day Overpayment Rule
- University of California, Hastings College of the Law (J.D. cum laude 1994); University of California, Berkeley (B.A. cum laude 1990)
- Pennsylvania and California