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Yale Law School, J.D., 1985

  • Notes and Topics Editor, Yale Law and Policy Review
  • Thomas I. Emerson Prize for Outstanding Legislative Services Project

Wichita State University, M.U.A., 1982

Wichita State University, B.A., 1980

Photo of D. Brian  Hufford

D. Brian Hufford

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D. Brian Hufford has developed a national practice representing patients and health care providers such as doctors, hospitals, and medical equipment companies in disputes with health insurance companies. He has experience in insurance and health care matters under Employee Retirement Income Security Act (ERISA) and related federal and state laws, having led litigation that resulted in two of the largest recoveries ever obtained in health insurance class actions. His work on litigation against United Healthcare led to a $350 million settlement, and in a similar action against Health Net, resulted in a $250 million settlement. Mr. Hufford also served as co-lead counsel in other national health care litigation against United, Aetna, WellPoint, CIGNA, and Blue Cross and Blue Shield entities. Recently, Mr. Hufford successfully argued health care appeals before the U.S. Courts of Appeal for the Second, Third and Fifth Circuits, and was lead counsel in two recent trials against Blue Cross and Blue Shield entities on behalf of providers and provider associations. He has been recognized in industry rankings such as Benchmark Litigation and Super Lawyers. Mr. Hufford also serves on the Editorial Advisory Board of BNA’s Health Law Reporter and is a member of the Kennedy Forum Legal Workgroup.

In addition to representing individual patients and health care providers, Mr. Hufford has pursued claims for a number of significant institutions, including medical associations such as the American Medical Association (AMA), Medical Society of the State of New York, American Dental Association, American Chiropractic Association, Congress of Chiropractic State Associations, New York Chiropractic Council, and Pennsylvania Chiropractic Association. He has also represented a number of unions in health care actions on behalf of their members, including the New York State United Teachers, Civil Service Employees Association, New York State Police Investigators Association, and Organization of NYS Management Confidential Employees.

Mr. Hufford has written and lectured extensively in the area of health care litigation. He has spoken at conferences and seminars sponsored by organizations such as the National Association of Attorneys General, American Medical Association,

American Corporate Counsel Association, American Chiropractic Association, and Congress of Chiropractic State Associations and the American Conference Institute for the National Forum on ERISA Litigation, among others.

Prior to entering private practice, Mr. Hufford spent two years as an honors attorney in the U.S. Department of the Treasury’s Honors Law Program. Mr. Hufford attended Yale Law School, where he was notes and topics editor for the Yale Law and Policy Review and was awarded the Thomas I. Emerson Prize for the Outstanding Legislative Services Project. He also holds a Bachelor of Arts and a Master of Urban Affairs from Wichita State University.

 

Professional Highlights

  • Mr. Hufford led the precedent-setting United Healthcare case, which settled on behalf of a nationwide class of providers and subscribers for $350 million in 2010, the largest settlement of an ERISA benefit class action in history. Retained by the American Medical Association and various other associations and individual plaintiffs, Mr. Hufford challenged United’s use of a flawed database to determine usual, customary and reasonable (UCR) rates for out-of-network services. The case served as a catalyst for then-New York Attorney General Andrew Cuomo’s investigation into the health insurance industry, leading to the creation of a new and independent database to provide UCR data. In an article in the New York Times on October 27, 2010 states that “a breakthrough came when lawyers for the attorney general’s office consulted” with Mr. Hufford, leading to a “collaboration” between the Attorney General’s Office and Mr. Hufford that “brought results.” In a similar action against Health Net, Mr. Hufford obtained a certified class of ERISA-insured patients followed in 2008 by a settlement valued at $249 million.
  • Mr. Hufford successfully argued before the U.S. Court of Appeals for the Second Circuit on behalf of the New York State Psychiatric Association and various individual mental healthcare providers and patients against United. In a precedent-setting decision, the Second Circuit confirmed in 2015 that United could be sued for benefits under ERISA and for violations of the Federal Parity Act, even with respect to self-funded plans, where United served solely as a claims administration. Amicus briefs were filed on behalf of Mr. Hufford’s clients by the U.S. Department of Labor, American Medical Association, American Psychiatric Association and Patrick Kennedy (the original sponsor of the Federal Mental Health Parity Act as a U.S. Representative from Rhode Island).
  • Mr. Hufford successfully argued before the Third Circuit on behalf of providers and plaintiffs in his own case and, as amici curiae, on behalf of the American Medical Association and the Medical Society of New Jersey in a related case, Accepting Mr. Hufford’s argument, the Third Circuit issued a precedent-setting decision in 2015 confirming that providers who have been assigned the right to receive benefit payments from their ERISA-insured patients are legally entitled to assert legal claims under ERISA to challenge benefit denials.
  • In an action against United on behalf of one of the nation’s largest surgical implant providers, Mr. Hufford was retained to pursue an appeal to the U.S. Court of Appeals for the Fifth Circuit after the district court held that a provider’s state court claims against United were preempted by ERISA. Arguing the appeal before the appellate panel, Mr. Hufford succeeded in reversing the decision by a 3-0 vote, based on the allegations that United made affirmative misrepresentations to the provider over whether it could bill and be paid directly by United for its services, which did not implicate the underlying purpose of ERISA. Thereafter, United sought en banc review, after which Mr. Hufford persuaded the Department of Labor to file an amicus brief in support of its position, and to participate in oral argument. Mr. Hufford successfully argued the appeal before the en banc panel, which unanimously found our client’s favor. United then filed a petition for writ of certiorari, which the U.S. Supreme Court denied on February 25, 2013, leaving the Fifth Circuit’s decision intact.
  • Mr. Hufford represented a durable medical equipment provider challenging repayment demands issued by Aetna for previously paid benefits as in violation of ERISA. The complaint brought on behalf of the client was initially dismissed by the district court, and Mr. Hufford successfully reversed the decision before the U.S. Court of Appeals for the Third Circuit.
  • Mr. Hufford represented two health care providers who were sued for billing fraud. After successfully removing the case to federal court, with a finding that ERISA completely preempted the fraud claims, he was lead trial counsel in a 20-day ERISA bench trial. A complete judgment in favor of his clients was obtained, enjoining the insurer from seeking to recover previously paid benefits and ordering returning of improperly recouped funds, plus interest.
  • Judge Faith Hochberg appointed Mr. Hufford as Chair of the Plaintiffs’ Executive Committee in In re Aetna UCR Litigation, an MDL action challenging how Aetna paid for out-of-network health care services. In appointing Mr. Hufford, Judge Hochberg specifically addressed his work in a prior healthcare litigation, stating: “The Court similarly appointed [Mr. Hufford’s firm] to be Plaintiffs’ spokesman to the Court in the Health Net litigation because the Court found D. Brian Hufford, Esq. to be the attorney most capable of presenting Plaintiffs’ position in a clear and concise manner.”
  • Mr. Hufford represented chiropractors and state chiropractic associations challenging Aetna’s policy of making repayment demands and placing providers into prepayment review. He defeated Aetna’s motion to dismiss, upholding ERISA claims on behalf of the providers.
  • Mr. Hufford represented the American Chiropractic Association, the Congress of State Chiropractic Associations, various state associations, and individual providers in an action challenging UnitedHealth Group’s repayment demand policy and improper restrictions on coverage for chiropractic services. He defeated the defendant’s motion to dismiss, upholding ERISA claims on behalf of providers.
  • Mr. Hufford represented subscribers in Health Net policies who were subject to reduced benefits based on the application of a uniform database for determining usual, customary, and reasonable (UCR) rates for out-of-network services, which Health Net acquired from Ingenix. The U.S. District Court for the District of New Jersey certified a nationwide class of subscribers under ERISA and RICO, and approved a $249 million settlement.
  • Mr. Hufford represented the American Medical Association, various other medical associations, New York-based unions, and individual providers and subscribers suing United Healthcare for its improper usual, customary, and reasonable (UCR) database. During the course of litigation, Mr. Hufford achieved significant decisions on key legal issues. The case ultimately settled for $350 million.
  • Mr. Hufford represented patients who were subjected to the imposition of improper length-of-stay guidelines for hospitalization. The defendant’s motion to dismiss was denied, and the decision was upheld on appeal by 5-0 vote.
  • Mr. Hufford represented insurance subscribers in action against Healthsource, Inc. for failing to disclose the financial incentives it paid to providers to encourage reductions in the level of care provided. He defeated the defendant’s motion to dismiss, and the court upheld his clients’ claims that the insurer had breached its fiduciary duties under ERISA.

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