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Ed Stumpp counsels clients on matters involving health plan liability, healthcare service contracts, medical claims, and ERISA litigation. He regularly handles jury trials, administrative hearings, arbitrations and appellate arguments involving specialized healthcare issues including commercial health plan network disputes, claims against MA Plans, other health plan service organizations, and independent practice associations (IPAs). His practice is focused on assisting health plans clients with payer-provider disputes, (both contracted and nonparticipating providers) that include medical and behavioral health claims as well as bad faith claims and de-selection issues in state and federal courts and arbitrations.

Ed also has represented extend care and skilled nursing facilities against allegations of elder abuse and he has a background in commercial litigation matters involving secured lenders and unsecured creditors in bankruptcy matters and other creditor actions.

Professional Background

Before joining Hinshaw, Ed practiced at the Los Angeles location of a San Francisco-based international firm.

While serving as a captain in the U.S. Marine Corps, Ed worked under the Staff Judge Advocate’s Office as a criminal defense trial attorney. Ed also spent a year as the aide-de-camp to the Commanding General of MCAS El Toro where he was involved in land use, air space and other issues related to the local community.

Professional Affiliations

  • American Health Lawyers Association, Member, 2015–Present
  • Kentucky State Bar, Member, 1985–Present
  • California State Bar Association, Member, 1983–Present
  • California Society for Healthcare Attorneys, Former Member

Representative Matters

  • Health Plan vs National Hospital Chain (2016): TRO issued enjoining termination of health care services agreement.
  • Medical Group/IPA vs. Medicaid Health Plan (2015): Medical group sought injunctive relief to prevent without cause termination of health services agreement. Petition for injunction denied.
  • Plaintiff vs. Health Plan (2014): Seven-week wrongful death/elder abuse jury trial involving multiparty litigation seeking to hold managed care health plan liable for decisions made at the medical group and physician level.
  • Hospital vs. Health Plan (2013): Claims of underpayment for patient’s place in observation status. Arbitration award for health plan.
  • Plaintiff vs. National Health Plan (2008): Wrongful death, bad faith. Superior Court action, jury trial. Nonsuit granted; Upheld on appeal (2011).
  • Hospital System vs. Regional Health Plan (2008): Underpayment of claims regarding failure to meet per diem threshold. Binding arbitration. Dismissed for nominal settlement.
  • Plaintiff vs. Medicaid Health Plan (2008): Wrongful death, bad faith. Superior Court action. Dismissed for nominal settlement.
  • Class of Primary Care Physicians vs. Regional Health Plan (2008): Statutory violation due to underpayment of nonexclusive physicians. Superior Court. Motion for summary judgment granted.
  • Plaintiff vs. Regional Health Plan (2007): Wrongful death, bad faith. Superior Court action. Motion for judgment on the pleadings granted based upon ERISA preemption.
  • Plaintiff vs. Regional Health Plan (2007): Bad faith. Superior Court. Demurrer granted based upon Medicare preemption.
  • Plaintiff vs. Regional Health Plan (2006): Bad faith. Demurrer granted for failure to state cause of action against health plan.
  • Regional Health Plan vs. Hospital System (2005): Mistaken overpayment of claims. Binding arbitration. $7 million award obtained for health plan.
  • Dentist vs. Regional Dental Health Plan (2004): Wrongful termination of provider contract. Binding arbitration. Award in favor of health plan including attorneys' fees incurred defending action.

Presentations

Ed is a regular speaker and commentator at healthcare seminars and conferences. He has given seminars on trial strategies, techniques and how to present a defense case.

His presentations include:

  • Moderator, "Trends and Updates in Litigation Risks Facing Plans," Managed Care Disputes and Litigation, American Conference Institute's 6th Annual Advanced Forum, Chicago, IL, May 14, 2015

Publications

  • Co-author, "New California Provider Playing Field Benefits Patients," Law360, August 12, 2014

News

Community/Civic Activities

Ed is an avid sailor and successfully completed the 2013 Transpac from Long Beach, California to Honolulu.

J.D., University of Kentucky College of Law, 1985

B.A., Centre College, 1982