Shareholder

Los Angeles, Orange County

Direct: 213.891.5224

Office: 213.891.0700

dmedina@buchalter.com

Bar Admissions

California, New York

Languages

Spanish

Overview

|

Damaris Medina is a Shareholder in Buchalter’s Los Angeles and Orange County offices, where she serves as Co-Chair of the Health Care Practice Group and Chair of the Firm’s Health Systems & Hospitals Industry Group. A nationally recognized health care attorney, Ms. Medina brings more than 15 years of experience representing hospitals, health systems, and other health care providers in complex litigation, reimbursement, 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.

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 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 as one of the Best Lawyers in America and among the Most Influential Women Attorneys by the Los Angeles Business Journal, Ms. Medina also received the California Lawyer of the Year (CLAY) Award for her work in health care law. She has been consistently named a “Rising Star” and one of the “Top Women Attorneys in Southern California” by Super Lawyers Magazine since 2014.  Ms. Medina has been published and quoted in Law 360, JD Supra, and California Health Law News, and is a frequent speaker for the California Hospital Association, HFMA, the American Bar Association and the American Health Law Association on hospital reimbursement and managed-care litigation trends and strategies.

In addition to her extensive work with hospitals and health systems, Ms. Medina represents a wide range of health care clients, including urgent care centers, emergency physician groups, billing companies, specialty physician practices, pharmacies, dentists, and health care consulting firms. She also handles complex business and commercial litigation, including class actions, shareholder disputes, breach of contract, and FINRA arbitration.

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.*

Business/Commercial Litigation

  • 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)*

Fraud & Abuse

  • 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.*

Administrative Law

  • 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.”

Admissions

  • California
  • 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

  • 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 – 2026.

  • Urgent Care Association of America, Director of the Board and Past-Treasurer
  • California Urgent Care Association (California Chapter of UCAOA), Director of the Board and President-Elect
  • California Chapter of the American College of Emergency Physicians
  • Orange County Bar Association, Co-Chair Activities Committee, Health Care Law Section
  • American Bar Association, International Law Section
  • Los Angeles County Bar Association, Health Care Law Section

Featured Content