Chemical Law & Prop 65
Damaris L. Medina
Practice Expertise
- Litigation
- Health Care
Areas of Practice
- Litigation
- Health Care
Profile
Damaris Medina is Co-Chair of Buchalter's Health Care Practice Group, Health Care Dispute Resolution Practice Group, and Health Care & Life Sciences Industry Group, and serves as Chair of the Firm's Health Systems & Hospitals Industry Group. A Partner in the Firm's Los Angeles and Orange County offices, Ms. Medina is a nationally recognized health care attorney with more than 15 years of experience advising and representing hospitals, health systems, and other health care providers in complex litigation, reimbursement disputes, and regulatory matters.
Ms. Medina's practice focuses on managed care litigation involving commercial and Medicare/Medicaid plans, where she has successfully litigated numerous high-value reimbursement disputes against major health plans-recovering millions of dollars for her provider clients. Her experience spans both out-of-network disputes, where she establishes the reasonable value of hospital and physician services, and in-network matters involving unfair payment practices, medical necessity, and coding denials. She represents clients in arbitration, state, and federal courts nationwide.
Ms. Medina also represents hospitals, health systems, physician organizations, and other health care entities in complex disputes beyond reimbursement, including contractual and business disputes, strategic affiliations and joint ventures, physician and medical staff matters, regulatory and compliance-related litigation, and False Claims Act matters. Her deep understanding of health care operations allows her to approach these disputes with insight into the regulatory, operational, and financial considerations that drive both the litigation and the client's broader business objectives.
Beyond litigation, Ms. Medina provides strategic counsel to hospitals and health systems on managed care contracting, revenue cycle optimization, regulatory compliance, and risk management. She works closely with executive, legal, and operational leadership to develop practical, forward-looking solutions that address the immediate issue while protecting business objectives, preserving important relationships where appropriate, and reducing future risk. She also defends providers in government and private payor audits, False Claims Act investigations, and enforcement actions brought by agencies such as the Department of Justice (DOJ) and the Office of Inspector General (OIG).
Recognized by Chambers USA for her work in health care law, Ms. Medina has also been named one of The Best Lawyers in America® and one of the Most Influential Women Attorneys by the Los Angeles Business Journal. She is a recipient of the California Lawyer of the Year (CLAY) Award for her work in health care law and has been recognized by Super Lawyers as one of the "Top Women Attorneys in Southern California."
Ms. Medina is frequently published and quoted on health care law and managed care issues, including in Law360, JD Supra, and California Health Law News. She is also a frequent speaker for the California Hospital Association, HFMA, the American Bar Association, and the American Health Law Association on hospital reimbursement, managed care litigation trends, and litigation strategy.
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Ms. Medina's practice focuses on managed care litigation involving commercial and Medicare/Medicaid plans, where she has successfully litigated numerous high-value reimbursement disputes against major health plans-recovering millions of dollars for her provider clients. Her experience spans both out-of-network disputes, where she establishes the reasonable value of hospital and physician services, and in-network matters involving unfair payment practices, medical necessity, and coding denials. She represents clients in arbitration, state, and federal courts nationwide.
Ms. Medina also represents hospitals, health systems, physician organizations, and other health care entities in complex disputes beyond reimbursement, including contractual and business disputes, strategic affiliations and joint ventures, physician and medical staff matters, regulatory and compliance-related litigation, and False Claims Act matters. Her deep understanding of health care operations allows her to approach these disputes with insight into the regulatory, operational, and financial considerations that drive both the litigation and the client's broader business objectives.
Beyond litigation, Ms. Medina provides strategic counsel to hospitals and health systems on managed care contracting, revenue cycle optimization, regulatory compliance, and risk management. She works closely with executive, legal, and operational leadership to develop practical, forward-looking solutions that address the immediate issue while protecting business objectives, preserving important relationships where appropriate, and reducing future risk. She also defends providers in government and private payor audits, False Claims Act investigations, and enforcement actions brought by agencies such as the Department of Justice (DOJ) and the Office of Inspector General (OIG).
Recognized by Chambers USA for her work in health care law, Ms. Medina has also been named one of The Best Lawyers in America® and one of the Most Influential Women Attorneys by the Los Angeles Business Journal. She is a recipient of the California Lawyer of the Year (CLAY) Award for her work in health care law and has been recognized by Super Lawyers as one of the "Top Women Attorneys in Southern California."
Ms. Medina is frequently published and quoted on health care law and managed care issues, including in Law360, JD Supra, and California Health Law News. She is also a frequent speaker for the California Hospital Association, HFMA, the American Bar Association, and the American Health Law Association on hospital reimbursement, managed care litigation trends, and litigation strategy.
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Languages
Spanish
Bar Admissions
California
Massachusetts
New York
Education
Suffolk University Law School, J.D., cum laude - Certificate in International Law, with Distinction Phi Delta Phi International Legal Honor Society - Member
Tufts University, B.A., International Relations
Areas of Practice
- Litigation
- Health Care
Professional Career
Significant Accomplishments
Reimbursement/Managed Care Disputes
Professional Activities and Experience
Reimbursement/Managed Care Disputes
- Defeated potential dismissal of action by Prime Healthcare Services against Humana Insurance Company for alleged Medicare Advantage underpayments and won sanctions motion against Humana for misrepresenting the Medicare appeals process.
- Defeated potential dismissal of action by large hospital system against major health plan on lawsuit for reimbursement of claims regulated by the Department of Insurance, where previously there was no private right of action.
- Negotiated multi-million dollar reimbursement dispute against major Health Plan on behalf of National Hospital System.
- Represented emergency physician group in Centinela-Freeman Emergency Medical Associates v. Health Net of California. In a unanimous published decision, the court of appeal reversed the trial court and held in favor of the ER doctors. Finding the HMOs' conduct demonstrated negligence and showed a degree of "callousness," the court ruled that negligent delegation is a viable cause of action in California. This decision has had a profound impact on the health care industry as a whole.*
- Obtained a favorable result on behalf of a provider against a county-organized health system that systematically down-coded and underpaid thousands of claims. The case led to a string of newspaper articles and the resignation of several individuals.*
- Represented a national health care consulting company in a shareholder derivative action in the Chancery Court of Delaware. Our client was having difficulty with one of its corporate shareholders, who were locking out the board and impinging on the company's ability to diversify its business and take advantage of other potentially lucrative opportunities. After learning that the troubled shareholder had principals that had been imprisoned for tax evasion and money laundering, we facilitated our client being able to buy its shares. After a highly contested litigation, a settlement was secured less than a week before trial that allowed the client to part ways with the shareholder, giving it the ability to freely conduct business. (See MCAG v. RNP)*
- Successfully represented an emergency medical group that was sued as a cross-defendant in a $50 million unfair competition case between a major health plan and a large hospital system. The health plan claimed that the hospital and our client defrauded the health plan, along with members of the general population, and challenged stability determinations made by the treating physicians. Successfully handled litigation between the two health care titans, attending over 100 days of depositions, managing the ESI production of a million pages of documents and working to secure a dismissal her client from the lawsuit. (See Prime v. Kaiser)*
- Represented a large provider in an Office of Inspector General (OIG) coding investigation, obtaining a total dismissal for her client.*
- Represented owners of hospital system in false claims qui tam suit relating to violations of the Stark & Kickback laws obtaining favorable settlement for client.
- Successfully represented an emergency physician group being investigated by the Office of Inspector General for coding and billing irregularities, and other health care fraud as a result of a sealed qui tam suit filed under the False Claims Act. Negotiated with the Assistant U.S. Attorney to decrease the scope of the government subpoena, and retained experts to review the group's billing and coding to corroborate the absence of fraud and abuse. She successfully defended the group, which resulted in the government choosing not to intervene in the qui tam suit, and the action being dismissed.*
- Represented numerous substance abuse treatment facilities in recoupment requests and audits from major payors.*
- Successfully represented a psychiatrist after a national health plan improperly terminated the provider's contract based on complaints regarding the psychiatrist's use of an alleged controversial treatment called "transcranial magnetic stimulation therapy."
Professional Activities and Experience
- Nominated by LA Times B2b Publishing as a 2024 Top LA Inspirational Women
- Recognized by LA Times B2b Publishing as a 2023 "DEIA Visionary"
- Nominated by LA Times B2b Publishing as a 2023 Top OC Inspirational Women
- Recognized by The Orange County Business Journal as a "Leader of Influence: Women in Law" 2023 & 2024
- Nominated by BTI Consulting as a 2022 Client Service All-Star in Healthcare Litigation
- Nominated by the Los Angeles Business Journal for the 2021 Women's Leadership Series and Awards
- Named one of Los Angeles Business Journal's "Women of Influence: Health Care" in 2021
- Named a Top Health Care Lawyer of 2019 & 2020 by the Daily Journal
- Nominated as one of the "Top Women in Business" by the Orange County Business Journal, 2019-2020
- Selected as a Finalist at the Los Angeles Business Journal's Health Care Leadership Forum & Awards in 2019
- Named One of the "Most Influential Women Attorneys" in Los Angeles, California by the Los Angeles Business Journal in 2018 & 2019
- Named the "California Lawyer of the Year" in Health Care by California Lawyer in 2017
- Selected for inclusion in "Super Lawyers' Top Women Attorneys in Southern California" in 2014 - 2018 and "Super Lawyers' Rising Stars" in 2017-2021
- Received 2017 Leading Lawyer Rising Star Award by Ambulatory M&A Advisor
- Named One of "36 People to Know in Urgent Care" by the Ambulatory M&A Advisor in 2015
- Recognized as one of the Best Lawyers in America, Health Care Law, 2023 - 2025.
Articles
Protecting Your Urgent Care Center Against Whistle-Blowers
The Sword and the Shield: Best Hiring Practices for Urgent Care Facilities
Audits by Managed-Care Organizations and Regulatory Agencies," The Textbook of Urgent Care
Dealing with Problem Employees in a High-Stakes Environment: Best Practices for Urgent Care Centers
Doing Due Diligence for Employees
Identifying Risks and Finding Shelter in an Urgent Care Compliance Program
Optimizing Analytics for Hospitals in a Value-Based Era
The Bottom Line
How Data Analytics Can Revive Hospitals' Revenue Cycle Management
A Roadmap to Audit Complexities and Defense Strategies
Ignorance is NOT bliss - The Risks and Rewards of Compliance
Ask a Lawyer - Discussion Group
Building a Culture of Compliance
Ask a Lawyer - Discussion Group
Urgent Care Centers: Corporate Practice of Medicine, State Licensure, EMTALA, Reimbursement Compliance
Compliance
Reimbursement 101: Getting Paid
Top Legal Issues Facing Urgent Care
Contract Negotiations
Coding Audits and Compliance
Smart Strategies for Employee Termination
Tactics for Combating Unfair Claims Settlement Practices
Damaris Medina, Speaker at Emergency Department Practice Management Association (EDPMA) Workshop
Damaris Medina, Presenter at American Health Law Association
Damaris Medina, Speaker at the ABA 25th Annual Emerging Issues in Healthcare Law Conference
Damaris Medina at the 2024 Dispute Resolution Spring Conference
The Sword and the Shield: Best Hiring Practices for Urgent Care Facilities
Audits by Managed-Care Organizations and Regulatory Agencies," The Textbook of Urgent Care
Dealing with Problem Employees in a High-Stakes Environment: Best Practices for Urgent Care Centers
Doing Due Diligence for Employees
Identifying Risks and Finding Shelter in an Urgent Care Compliance Program
Optimizing Analytics for Hospitals in a Value-Based Era
The Bottom Line
How Data Analytics Can Revive Hospitals' Revenue Cycle Management
A Roadmap to Audit Complexities and Defense Strategies
Ignorance is NOT bliss - The Risks and Rewards of Compliance
Ask a Lawyer - Discussion Group
Building a Culture of Compliance
Ask a Lawyer - Discussion Group
Urgent Care Centers: Corporate Practice of Medicine, State Licensure, EMTALA, Reimbursement Compliance
Compliance
Reimbursement 101: Getting Paid
Top Legal Issues Facing Urgent Care
Contract Negotiations
Coding Audits and Compliance
Smart Strategies for Employee Termination
Tactics for Combating Unfair Claims Settlement Practices
Damaris Medina, Speaker at Emergency Department Practice Management Association (EDPMA) Workshop
Damaris Medina, Presenter at American Health Law Association
Damaris Medina, Speaker at the ABA 25th Annual Emerging Issues in Healthcare Law Conference
Damaris Medina at the 2024 Dispute Resolution Spring Conference
Blogs
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