Every business wants to cut costs, and health insurance companies are no exception. A new West Hartford law firm has been formed to help resolve the thousands of disputes that arise when doctors, hospitals and other medical providers send bills to insurers requesting compensation for patients’ medical care.
The new firm is called Mueller Pierce, and it combines the investigative fraud protection specialty of Connecticut lawyer Howard L. Pierce with the litigation skills of Texas trial lawyer Mark Mueller.
One of the firm’s first three attorney hires got his start as an investigative newspaper reporter. That makes sense, as the new firm’s tactics include combing through billing records and documents prepared by doctors’ offices and clinics. The firm’s lawyers and investigators, working on behalf of insurance companies, analyze the medical billing records to find charges that are out of line, either by mistake or intention.
Founding partner Pierce worked for 16 years as a federal agent before leaving to work for numerous law firms, including Shipman & Goodwin and McElroy, Deutsch, Mulvaney & Carpenter.
While working at Shipman for 13 years, Pierce said he perfected use of database technology to crunch medical claims and payment information, looking for patterns that would allow him to sniff out fraud. The practice of data mining, Pierce explained, can uncover billing patterns of health care providers and reveal questionable claims.
Years ago, “like everyone else,” Pierce said he would identify health care providers that were overbilling insurers and “start out calling everyone frauds.”
But over time, he’s become less confrontational. Now, using the database he devised to compare multiple claims and cross-reference that information with witness interviews, Pierce approaches medical providers with ample evidence of questionable health care bills. Pierce then tries to resolve claims of overbilling short of trial “in a business to business atmosphere,” he said.
The statistical research from his firm’s own database gives his side leverage when it comes to reaching settlements that are “favorable, sometimes very favorable.”
In recent years, Pierce’s settlements have routinely run into eight-figure amounts. The new team in West Hartford will handle cases from across the country, representing third-party payers of insurance claims, as well as insurance companies themselves.
Mueller brings to the practice a medical staff who works with him, as well as in-house experts who help shape the cases.
The attorney, who will remain in Austin, Texas, has made his name as a lawyer through years of experience in victim’s rights litigation and expert witness preparation. Mueller has offices in Philadelphia and Atlanta.
In addition to handing claims of medical office overbilling, Mueller Pierce will also represent clients in whistleblower cases, complex civil tax cases, white collar defense and product liability. To get the job done, Pierce said, the firm has hired two lawyers in West Hartford.
A legal analyst, Michael J. Marrion, will investigate medical billing claims.
As a partner at the new firm, Timothy Cornell, will work in commercial, securities and antitrust litigation. Before joining Mueller Pierce, Cornell was part of the team that sued Visa, Mastercard and several banks in an antitrust claim on behalf of American Express. In that case, a settlement of $4 billion was reached, the largest in antitrust history.
Before that big case, Cornell cut his teeth as an investigative reporter for the Boston Herald and then the Philadelphia Inquirer. Even then, his journalism was leading to big verdicts. In 1998, Vanderbilt University agreed to a $10 million settlement in lawsuits brought by women who were part of a pregnancy study conducted by the university in the 1940s. That lawsuit started with an investigative story that Cornell wrote for the Tennessean newspaper in Nashville.
Also joining the new firm is Stephanie M. Gitlin. She was previously a litigator with Shipman & Goodwin, where she represented national and regional healthcare companies in overpayment cases.•