Biography

Gary Pancer focuses his practice on general civil, business and healthcare litigation.  Mr. Pancer has extensive experience representing healthcare service plans, physicians and other healthcare clients in complex business litigation and consumer disputes including bad faith litigation.  He also represents healthcare clients in administrative proceedings before the Department of Managed Health Care, the Medical and Dental Boards of California, U.S. Department of Labor and other state and federal agencies.

Mr. Pancer has successfully litigated many cases on behalf of healthcare clients in trial courts and binding arbitration, including several multi-million dollar business and consumer cases.  He frequently advises healthcare clients concerning general risk management issues.  Prior to becoming a lawyer, Mr. Pancer worked for several years in a management position for a large publicly traded HMO.

Representative Matters

• Obtained defense trial judgment on behalf of our client, a national provider of industry-leading workers compensation products and physician network in a wrongful termination suit brought by an orthopedic surgeon which included claims of breach of contract, violation of B&P Section 17200, retaliation, violation of fair process, negligent infliction of emotional distress, defamation, misrepresentation and violation of the Knox-Keene Act. Plaintiff sought damages in excess of $4 million.
• Obtained defense award on behalf of a large health plan in a multi-million dollar provider dispute after multimonth binding arbitration regarding managed care risk pools. Also recovered award of attorneys fees as prevailing party which was upheld on appeal by the California Court of Appeal.
• Obtained fully favorable defense award in binding arbitration on behalf of Life & Health Plan in a multi-million dollar dispute brought by a Taft-Hartley Trust Fund regarding enrollee eligibility.
• Acted as co-lead national counsel for a Pharmacy Benefit Manager (PBM) in multi-district litigation involving allegations of unlawful business practices related to formulary decisions and pharmacy rebate arrangements with a large pharmaceutical company.
• Obtained non-suit on first day of jury trial from an Orange County Superior Court judge in a consumer lawsuit regarding allegations of bad faith and unlawful business practices.
• Successfully obtained numerous judgments following the granting of demurrers without leave to amend in various state courts throughout California in member litigation on federal preemption grounds including Medicare, ERISA and FEHBA.
• Obtained Temporary Restraining Order ("TRO") in Orange County Superior Court on behalf of large health plan against national hospital chain preventing unlawful termination of managed care contract that would have resulted in potential patient harm in having to immediately re-assign thousands of enrollees to alternate providers in the middle of care.
• Obtained voluntary dismissal on behalf of a large health plan from Plaintiffs in a class action involving allegations of unlawful business practices pertaining to third party liability recovery practices.
• Obtained summary judgment from state court on behalf of specialized behavioral health plan in a bad faith and unlawful business practices claim related to the denial of residential treatment for anorexia.
• Obtained summary judgment on behalf of large health plan in a bad faith and unlawful business practices case involving allegations of wrongful denial of out-of-network services where claim was that appropriate services were not available within the HMO network.
• Obtained summary judgment on behalf of large health plan in a bad faith and unlawful business practices case involving allegations of wrongful denial of proton beam radiation therapy for prostate cancer.
• Successfully defended large health plan in numerous lawsuits brought by hospital and medical groups involving contract and risk pool disputes.
• Successfully defended large health plan and provider groups in claims brought by non-contracting emergency providers regarding reasonable and customary charges.
• Successfully defended large health plan in numerous Administrative Law Judge hearing through the Social Security Administration as well as Medicare Appeals Council on Medicare coverage disputes.
• Successfully defended specialized vision plan in interference with business practices claim brought by terminated provider.

Presentations

• Speaker, “Litigation Risk Management,” RxSolutions, Inc., Irvine, California (May, 2011).
• Speaker, “The Shifting UR/QM Liability-Best Practices in Risk Management,” California Association of Physician Groups (CAPG) Southern California General Membership Meeting, Los Angeles, California (September, 2010).
• Speaker “The Shifting UR/QM Liability-Best Practices in Risk Management,” California Association of Physician Groups (CAPG) Northern California General Membership Meeting, Oakland, California (June, 2010).
• Moderator, “Prescription for Conflict: The Scope of Federal Preemption under Medicare Parts C and D,” The American Bar Association Health Law Section (January 13, 2010).
• Moderator, “Health Plans Vicarious Liability for Network Provider's Acts or Omissions,” American Health Lawyers Association Teleconference (April 23, 2009).
• Speaker, "Retroactive Rescission of Health Plan Contracts," State Bar of California Annual Meeting, Monterey, California (September 2008).
• Speaker, "Medicare Preemption of State Law Tort Claims Under the MMA," Four Seasons, Westlake Village, California (February 2008).
• Speaker, "Recent Developments In Managed Care Litigation," The Hartford Club, Hartford, Connecticut (September 2007).

Publications

• Co-author, “Common Managed Care Disputes,” Chapter 2 of Managed Care Litigation, 2011 Cumulative Supplement, published by the Bureau of National Affairs, Inc. (May 2011).
• Author, “Insurance Coverage for Treatment of Autism: Legal Trends in California and Nationwide,” California Health Law News, Vol. XXIX, Issue 2 (Spring 2011).
• Co-author, "Recent Trends in Insurance Coverage Litigation for Treatment of Autism," Sedgwick's Healthcare Law Newsletter (Winter 2011).   
• Co-author, “Common Managed Care Disputes,” Chapter 2 of Managed Care Litigation, 2010 Cumulative Supplement, published by the Bureau of National Affairs, Inc. (May 2010).
• Co-author, “Common Managed Care Disputes,” Chapter 2 of Managed Care Litigation, published by the Bureau of National Affairs, Inc. (May 2009).
• Co-author, “Court Expands Fair Procedure Rights Regarding Admission to Healthcare Provider Networks,” Sedgwick Healthcare Law Newsletter (Summer 2008).
• Author, “Court Rules Unlicensed, Out-of-State Physician Subject to Prosecution for Web Prescriptions,” Sedgwick Healthcare Law Newsletter (Summer 2007).
• Co-author, "Recent Developments in Medicine and Law," Tort Trial & Insurance Practice Law Journal , American Bar Association, Volume 40, No. 2 (Winter 2005).
• Author, "The Role of Cost-Effectiveness in Managed Care Contracts," Health Plan & Provider (BNA), Volume 10, No. 31 (August 10, 2004).
• Author, "Lanterman Centeres Are Not Liable for Provider Actions," Los Angeles and San Francisco Daily Journal (February 18, 2004).
• Moderator, "Health Plan External Review-Effective Mediation or Liability Landmind?," American Health Lawyers Association (February 2004).

Memberships & Honors

Mr. Pancer is a member of The American Health Lawyers Association, the Healthcare Law Section of the Los Angeles Bar Association and the California Society of Healthcare Attorneys. 

He is the immediate past president and serves on the board of directors of the Frank D. Lanterman Regional Center, a non-profit organization that provides services to thousands of children and adults with developmental disabilities in the greater Los Angeles area.  He also serves as vice president of Newbury Park Pony Baseball, serving more than 700 children (ages 5-15).

Mr. Pancer recently successfully represented a young man from the African country of Eritrea in a pro bono matter, obtaining grant of asylum by the U.S. Immigration Court under the Convention Against Torture.  Mr. Pancer is also actively involved in representing holocaust survivors in the ZRBG Pension Project through the Bet Tzedek Holocaust Survivors Justice Network.