Poth, James Lenahan

Current Employment Position(s)

Partner

Lawyer Overview

For more than a decade, Jim Poth has assisted hospitals, health systems, 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 Tenet Healthsystem and Cedars-Sinai Medical Center against health plans over appropriate payment for emergency care in the absence of contract rates ("reasonable and customary" versus billed charges). He also represented Catholic Healthcare West in an arbitration against Blue Cross of California over the practice of retroactively rescinding individual health insurance policies after patients had received care. These cases follow his representation of providers asserting claims of breach of contract, statutory violations, and fraud against health plans. He also has represented hospitals in litigation 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.

Areas of Practice

• Health Care
• Trial Practice
• Litigation/Health Care
• Airlines & Aviation

Representative Cases

• Alvarado Hospital arbitrates dispute with health plan over billing audits and compliance with California law
• Applied Medical Resources defends against trade secret theft claims and prevails in malicious prosecution trial
• Catholic Healthcare disputes claim denials
• Cedars-Sinai Medical Center in payment dispute with PacifiCare
• Desert Regional Medical Center receives payment for claim
• MedPartners defended in unfair business practice claim
• Southern California Medical Corporation fights to keep patient lists
• Tenet Healthcare in dispute with Medical Savings Insurance Company
• Tenet Healthcare in dispute with Quest Diagnostics , (2009)
• Tenet Healthcare Systems achieves favorable settlement in arbitration for unpaid reimbursement
• Tenet HealthSystem challenges contracted rates
• Tenet HealthSystem defeats PacifiCare's counterclaims of overpayments
• Tenet in arbitration with Molina over contract claims breach
• Tenet secures summary judgment precertification in debt collection putative class action
• Tenet wins dismissal of ERISA suit
• UWMC Hospital in dispute over equipment lease
• Valley Doctors Hospital defends against health plan claim for repayment
• Vanguard Health Systems secures dismissal in suit alleging injury and improper billing of Medicare patients , (2009)
• Whittier Hospital recovers costs from Blue Shield , (2009)

West Practice Categories

Bankruptcy Litigation, Class Actions, Complex Litigation, Disability, Elder Law, Federal Appellate Practice, Federal Claims Court, Federal Trial Practice, Food & Drug Administration, Health & Health Care Law, Hospital Law, International Trade Litigation, Litigation & Appeals, Medicare & Medicaid, Mental Health, Military & Veterans Appeals, Multidistrict Litigation, Nursing Home, Patent Litigation, Social Security -- Disability, State Appellate Practice, State Trial Practice, Tax Litigation, US Court of Appeals for the Federal Circuit, US Supreme Court

Bar Admissions

• California
• Pennsylvania

Education

• U of California - Berkeley
• U of California - Hastings

Address

3161 Michelson Drive, Suite 800
Irvine, CA 92612-4408

Phones

1.949.553.7586 (Business Phone)

Faxes

1.949.553.7539 (Business Fax)

Emails

Contact Us (Business Email)

Websites

http://www.jonesday.com