David E. Kopans

David Kopans focuses his practice on the representation of clients in the health care and health insurance industries. His experience includes advising on a wide range of matters related to health care reform under the Patient Protection and Affordable Care Act, including the insurance market rules governing health insurance issuers and group health plans, qualified health plan certification by health insurance exchanges, essential health benefits, mental health parity rules, internal appeals and external review procedures, minimum loss ratio compliance, and student health insurance regulatory compliance.

David regularly assists clients in the formation and acquisitions of health insurers and provider-based plans; prepares insurance, TPA, PBM, and provider network licensure and registration applications; drafts evidence of coverage and other insurance forms; represents health plans and providers in managed care contract negotiations and drafting; prepares insurance regulatory filings, including Forms A, B, and D filings; negotiates services agreements with and on behalf of carriers, TPAs, PBMs, and other vendors; and assists in the development of, and contracting for, clinically integrated networks, accountable care organizations, and various Medicare initiatives and programs, such as the BPCI Initiative, Medicare Shared Savings Program, and Next Generation ACO Model. [1]