Karen George is Senior Counsel in the Firm’s Litigation and Health Care Practice Groups, where her practice focuses on managed care litigation and complex health care reimbursement disputes. She represents a broad range of health care providers, including hospital systems, physician groups, emergency department physicians, and other health care providers in matters involving reimbursement by commercial payors, Medicare Advantage and Medicaid managed care plans, third-party administrators, and self-funded employer health plans.
Ms. George helps health care providers maximize reimbursement by resolving complex disputes with health plans through litigation, arbitration, negotiation, and strategic counseling. She has successfully litigated numerous high-value reimbursement disputes against some of the nation’s largest health plans, recovering millions of dollars on behalf of health care providers. Her experience spans both out-of-network reimbursement disputes involving the reasonable value of hospital and physician services and in-network payment disputes involving underpayments, medical necessity determinations, coding issues, and contract interpretation. She also has significant experience defending providers against large-scale overpayment allegations, government and private payor audits, and payer recoupment efforts.
Beyond dispute resolution, Ms. George advises providers on managed care contracting, reimbursement strategy, and revenue cycle optimization. She partners with clients to strengthen payer relationships, improve reimbursement outcomes, and develop practical, business-oriented strategies that support their long-term operational and financial objectives.