Daly D.E. Temchine Counsel
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1 5 Daly D.E. Temchine Counsel New York 250 Park Avenue New York, New York Tel: Fax: DALY D.E. TEMCHINE is Counsel in the Health Care and Life Sciences and Litigation practices, in the New York office of Epstein Becker Green. Since joining the firm in 1990, he has focused on providing representation, advice and counseling to clients in the health care industry. Mr. Temchine is recognized as one of the country's leading attorneys with regard to ERISA preemption matters. Mr. Temchine represents managed care entities, ERISA plans and plan sponsors, plan administrators, insurers, hospitals, vertically integrated provider groups, and physician groups and associations. He has litigated a wide range of health care law matters, including: ERISA Benefits coverage Experimental treatment CPT and DRG coding practice disputes Fraud and abuse claims Antitrust law as it relates to the health field "Anti-dumping" claims Peer review in hospital, HMO and IPA settings including claims of denials of due process and non-compliance with medical staff and hospital bylaw requirements Federal and state statutory and regulatory governance of health care financing and delivery systems EMTALA Alternative dispute resolution provisions in plan documents and provider contracts Mr. Temchine's experience also includes:
2 Counseling health care clients on issues concerning ERISA preemption, fiduciary breach, prohibited transactions, and denial of benefits Representing clients in managed care class action defense, including RICO, subrogation under both ERISA and state laws with respect to payments received by insureds from third party tortfeasors, retention of rebates by payers, state prompt pay laws as applied to both insured and self-funded health benefit plans, "Any Willing Provider Statute" litigation as applied to both insured and self-funded benefit plans Counseling clients on payer/provider billing disputes, including non-participating provider issues, Medicaid plan coverage and payment disputes, Medicare plan coverage and payment disputes, disputes regarding applicable payment rates under both state laws and contract terms Representing clients in hospital litigation, including EMTALA, disputes between hospital medical staffs and hospital boards and officers, disputes between affiliated hospitals, and exclusive contracting disputes Representing clients in the prosecution and defense of post-employment restrictive covenants and unfair competition claims Providing advice and guidance with respect to the development of- managed care service enterprises, selffunded health and welfare plans which comply with ERISA and involve an insurance factor without being either MEWAS or subject to indirect state regulation Providing advice and counsel to ERISA fiduciaries regarding the identity and characteristics of "plan assets" in connection with the avoidance of prohibited transactions Advising clients as to the proper ERISA scope of benefit and benefit limitation and exclusion description Providing fraud and abuse counseling and defense, both in general and in the context of specific government investigations Mr. Temchine has represented clients in numerous, significant lawsuits, including: Love v. Blue Cross and Blue Shield Ass'n (formerly Thomas v. Blue Cross and Blue Shield Ass'n), No , 2008 WL (S.D. Fl. Sept. 4, 2008) Solomon v. Blue Cross Blue Shield Ass'n, 574 F. Supp. 2d 1288 (S.D. Fla. 2008) Rubin-Schneiderman v. Merit Behavioral Care Corp., et al., 193 Fed. Appx. 70 (2d Cir. 2006), cert. denied, 2007 U.S. LEXIS 91 (U.S. Jan. 8, 2007) Singh v. Prudential Health Care Plan, Inc., 335 F.3d 278 (4th Cir.), cert. denied, 124 S. Ct. 924 (2003) Moreland v. Aetna U.S. Healthcare, Inc., 152 Md. App. 288 (2003) Connecticut v. Physicians Health Servs. of Conn., Inc., 287 F.3d 110 (2d Cir.), cert. denied, 537 U.S. 878 (2002) Batas v. Prudential Ins. Co., 281 A.D.2d 260, 724 N.Y.S.2d 3 (1st Dep't 2001) Prudential Ins. Co. v. National Park Med. Ctr., 154 F.3d 812 (8th Cir. 1998) Texas Pharmacy Ass'n v. Prudential Ins. Co., 105 F.3d 1035 (5th Cir. 1997) Turner v. Fallon Cmty. Health Plan, Inc., 127 F.3d 196 (1st Cir. 1997)
3 5 Mr. Temchine's litigation experience also encompasses both bench and jury trials in such diverse civil matters as race and gender discrimination, construction, antitrust, contracts and RICO cases. He has been retained by a number of trade associations to prepare amicus briefs in Supreme Court matters, including Herdrich v. Pegram, 530 U.S. 211, 120 S.Ct (2000), and has represented the managed care industry in the Supreme Court and the Circuit Courts of Appeal. Mr. Temchine first became involved in ERISA litigation in 1980 when he joined the Office of the Solicitor of Labor. As Deputy Associate Solicitor for Special Litigation and a Senior Trial Attorney, he was responsible for the civil prosecution of some of the more complex and precedent-setting actions brought by the Secretary of Labor to enforce ERISA. Mr. Temchine was lead counsel for the plaintiff Secretary in Donovan v. Schmoutey, 592 F. Supp. 1361, 1403 (D. Nev. 1984), involving the misapplication of the assets of a pension plan. The cased was tried to a jury for six months, and resulted in a verdict in excess of $30 million. Although the judgment debtors immediately filed for bankruptcy, Mr. Temchine and his team recovered more $26 million from the debtors' secured creditors in the bankruptcy proceeding. Mr. Temchine has been actively involved in health law since the early 1970s. As a Deputy Attorney General for the State of New Jersey, he had lead counsel responsibility for substantial class actions brought against the State in the federal courts, and prosecuted the first Medicaid fraud case brought by the State. Mr. Temchine entered private practice where he concentrated on civil litigation, with substantial involvement in class action defense, antitrust defense and hospital law respecting the relationship between hospital boards of trustees and officers and the one hand, and medical staff bodies and their officers on the other. Mr. Temchine clerked for the Hon. Melvin P. Antell. In 1997, Mr. Temchine was named by the National Law Journal as one of "40 Health Care Lawyers Who Have Made Their Mark." On March 29, 2002, he was the sole private practitioner invited to participate in a panel presentation at a conference of United States District Court judges at New York University Law School on the subject of anticipation and management of issues likely to arise in the litigation of ERISA cases. Mr. Temchine was recommended by The Legal 500 United States in Mr. Temchine writes and speaks frequently on issues related to ERISA. Education Rutgers University School of Law Newark (J.D., 1969) o Editorial Board, Rutgers Law Review Columbia College (B.A., 1965) Court Admissions Supreme Court of the United States U.S. Court of Appeals for the District of Columbia Circuit
4 U.S. Court of Appeals for the First Circuit U.S. Court of Appeals for the Fourth Circuit U.S. Court of Appeals for the Fifth Circuit U.S. Court of Appeals for the Eighth Circuit U.S. Court of Appeals for the Ninth Circuit U.S. District Court, Eastern District of Michigan U.S. District Court, Southern District of Illinois U.S. District Court, Southern District of New York Bar Admissions District of Columbia Maryland New Jersey New York Practice Areas Antitrust Counseling and Defense Appellate Behavioral Health Business Litigation Construction and Real Estate Litigation Employee Benefits Employment Litigation ERISA and Benefit Plan Litigation Federal & State False Claims Act Fraud and Abuse Counseling and Defense Government Investigations and Litigation Insurance Coverage and Reinsurance Disputes Managed Care Trade Secrets & Employee Mobility White Collar Criminal Defense and Internal Investigations Industries Health Care and Life Sciences Industry Health Plans and Other Insurers
5 5 Hospitals and Health Systems Physician Group Practices/Management Suppliers & Distributors Memberships American Bar Association American Health Lawyers Association District of Columbia Bar Association Maryland State Bar Association New Jersey State Bar Association News & Publications February 27, 2013 Benefits Litigation Update - February 2013 December 12, 2012 New Competitors in Health Insurance Marketplace: The Consumer Controlled, Operated, and Oriented Plan Federal Loan Program, as appeared in Bloomberg BNA's Health Insurance Report September 7, 2012 Benefits Litigation Update - September 2012 April 19, 2012 Benefits Litigation Update - April 2012 February 1, 2012 Health Reform: New Rules Issued on Medical Loss Ratio Requirements, as appeared in BNA's Health Insurance Report January 18, 2012 HEALTH REFORM: New Rules Issued on Medical Loss Ratio Requirements June 30, 2010 The Impact of the Health Reform Law on Self-Insured ERISA Health and Welfare Plans: A Guide for Employers
6 June 23, 2010 The Impact of the Patient Protection and Affordable Care Act on Self-Insured ERISA Health and Welfare Benefit Plans: A Guide for Administrators of Self-Insured Plans November 12, 2009 Epstein Becker Green Giving Back - Fall 2009 August 24, 2009 Second Circuit Decides in Woods v. Empire Health Choice, Inc. that Medicare Secondary Payor Act Is Not a Qui Tam Statute Plaintiff Must Show Individual Injury
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