Robinson Cole LLP
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Michael H. Bernstein concentrates his practice in the areas of the Employee Retirement Income Security Act (ERISA) and managed care litigation; life, health, and disability benefit litigation; and related insurance coverage issues.

Health + Benefits Litigation

Michael manages litigation from inception through trial, arbitration, and appeal and has successfully defended life, health, and disability claims brought in state or federal court against insurers, plan administrators, employers, and managed care organizations. Examples include cases governed by ERISA, the Federal Employees Health Benefits Act (FEHBA), and the Federal Employees' Group Life Insurance program. Michael regularly represents health maintenance organizations; preferred provider organizations; third-party administrators; pharmacy benefit managers; and life, health, disability, and accidental death and dismemberment benefit plans. In addition, he represents insurance companies, managed behavioral health care claim administrators, chiropractic health care claim administrators, self-funded plan sponsors, and administrators in a variety of matters.

Michael’s experience spans all areas of life, health, and disability litigation, including complex health care issues involving ERISA, FEHBA and Medicare preemption, payor/provider contract disputes, provider de-listing disputes, PBM antitrust claims, nonparticipating provider reimbursement claims, pharmacy benefit plan/provider disputes, and behavioral health claim disputes, including claims alleging violations of federal and state Mental Health Parity and Addiction Equity laws. He has also represented claim administrators and plan sponsors in class actions alleging breaches of ERISA fiduciary duty, violations of mental health parity laws, improper offsets against benefits for Social Security disability income benefits, and third-party tort settlements. Michael has also briefed and argued approximately 30 appeals in various U.S. Circuit Courts as well as before state appellate tribunals.

Michael has written extensively about managed care litigation, health care issues, group benefits, and ERISA matters, and has presented on these topics at conferences and seminars around the country.

Prior to joining Robinson+Cole, he was the chair of the health care practice group for an international law firm.

  • Pace University School of Law (Juris Doctor)
  • State University of New York at Albany (Bachelors, cum laude)
    • B.A., Rhetoric + Communication

  • State of Connecticut
  • State of New Jersey
  • State of New York
  • Commonwealth of Pennsylvania
  • State of Utah
  • U.S. Supreme Court
  • U.S. Court of Appeals, 1st Circuit
  • U.S. Court of Appeals, 2nd Circuit
  • U.S. Court of Appeals, 3rd Circuit
  • U.S. Court of Appeals, 4th Circuit
  • U.S. Court of Appeals, 6th Circuit
  • U.S. Court of Appeals, 9th Circuit
  • U.S. Court of Appeals, 10th Circuit
  • U.S. Court of Appeals, 11th Circuit
  • U.S. District Court, District of Colorado
  • U.S. District Court, District of Connecticut
  • U.S. District Court, District of New Jersey
  • U.S. District Court, Eastern District of New York
  • U.S. District Court, Northern District of New York
  • U.S. District Court, Southern District of New York
  • U.S. District Court, Western District of New York
  • U.S. District Court, Eastern District of Pennsylvania
  • U.S. District Court, Western District of Pennsylvania
  • U.S. District Court, District of Utah

Selected to the New York Metro Super Lawyers list for 2006, 2007, 2010 and from 2012 to 2017

American Arbitration Association
Arbitration Panel

American Bar Foundation
Fellow

International Association of Defense Counsel

American Bar Association
Health Law Section

New York State Bar Association
Torts, Insurance and Compensation Law Section

Defense Research Institute
Life, Health and Disability Committee - Healthcare Programming former chair
Medical Liability and Health Care Law Committee

American Health Lawyers Association

Experience


Successful Defense of Medicaid Managed Care Plan in Provider Reimbursement Arbitration

Represented a Medicaid managed care organization in an AHLA arbitration brought by a behavioral health provider alleging years of systemic underpayment. The arbitrator dismissed all claims in their entirety based on failure to exhaust contractual remedies and lack of entitlement to higher reimbursement rates, eliminating more than $1.5 million in claimed exposure.

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Summary Judgment Win in ERISA + Mental Health Parity Benefits Litigation

Obtained summary judgment for a national health insurer in federal court in an ERISA action challenging behavioral health benefit denials. The court upheld the insurer’s medical necessity determinations and plan exclusions and rejected Mental Health Parity Act claims, dismissing all core liability theories.

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Lead Trial Counsel in Six-Day Arbitration

Successfully defended arbitration commenced by in-network hospital seeking $73,000,000 on 50,000-plus claims. Served as lead trial counsel in six-day arbitration involving expert topics such as medical necessity, sampling methodology, statistical analysis, medical claim coding, and revenue cycle management. Hearing resulted in a highly favorable award, allowing significantly less than 1% of original claim.

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Publications


Legal Update: New York State Paid Sick Leave Takes Effect; New York City Amends Local Law to Conform, Impose Additional Requirements teaser
October 2, 2020

Legal Update: New York State Paid Sick Leave Takes Effect; New York City Amends Local Law to Conform, Impose Additional Requirements

Legal Update: EEOC Releases Updates to COVID-19 Technical Assistance Questions and Answers (COVID-19 Coronavirus) teaser
September 25, 2020

Legal Update: EEOC Releases Updates to COVID-19 Technical Assistance Questions and Answers (COVID-19 Coronavirus)

Legal Update: Federal District Court Expands Employee Paid Leave Rights Under FFCRA (COVID-19 Coronavirus) teaser
August 19, 2020

Legal Update: Federal District Court Expands Employee Paid Leave Rights Under FFCRA (COVID-19 Coronavirus)

Legal Update: New York State Paid Sick Leave Takes Effect; New York City Amends Local Law to Conform, Impose Additional Requirements teaser
October 2, 2020

Legal Update: New York State Paid Sick Leave Takes Effect; New York City Amends Local Law to Conform, Impose Additional Requirements

Legal Update: EEOC Releases Updates to COVID-19 Technical Assistance Questions and Answers (COVID-19 Coronavirus) teaser
September 25, 2020

Legal Update: EEOC Releases Updates to COVID-19 Technical Assistance Questions and Answers (COVID-19 Coronavirus)

Legal Update: Federal District Court Expands Employee Paid Leave Rights Under FFCRA (COVID-19 Coronavirus) teaser
August 19, 2020

Legal Update: Federal District Court Expands Employee Paid Leave Rights Under FFCRA (COVID-19 Coronavirus)

Legal Update: Paid Sick and Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus) teaser
April 2, 2020

Legal Update: Paid Sick and Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus)

Legal Update: Paid Sick and Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus) teaser
March 31, 2020

Legal Update: Paid Sick and Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus)

Legal Update: EPA Issues COVID-19 Enforcement Discretion Policy teaser
March 31, 2020

Legal Update: EPA Issues COVID-19 Enforcement Discretion Policy

Legal Update: Employers Take Note of the CARES Act: More Paid Sick And Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus) teaser
March 27, 2020

Legal Update: Employers Take Note of the CARES Act: More Paid Sick And Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus)

Legal Update: Need to Reduce Staff? Consider Shared Work Programs to Lessen the Pain (COVID-19 Coronavirus) teaser
March 26, 2020

Legal Update: Need to Reduce Staff? Consider Shared Work Programs to Lessen the Pain (COVID-19 Coronavirus)

Legal Update: New York Adopts Sweeping Paid Sick Leave Law (COVID-19 Coronavirus) teaser
March 20, 2020

Legal Update: New York Adopts Sweeping Paid Sick Leave Law (COVID-19 Coronavirus)



Legal Update: Paid Sick and Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus) teaser
April 2, 2020

Legal Update: Paid Sick and Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus)

Legal Update: Paid Sick and Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus) teaser
March 31, 2020

Legal Update: Paid Sick and Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus)

Legal Update: EPA Issues COVID-19 Enforcement Discretion Policy teaser
March 31, 2020

Legal Update: EPA Issues COVID-19 Enforcement Discretion Policy

Legal Update: Employers Take Note of the CARES Act: More Paid Sick And Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus) teaser
March 27, 2020

Legal Update: Employers Take Note of the CARES Act: More Paid Sick And Family Leave Legislation in Response to Coronavirus (COVID-19 Coronavirus)

Legal Update: Need to Reduce Staff? Consider Shared Work Programs to Lessen the Pain (COVID-19 Coronavirus) teaser
March 26, 2020

Legal Update: Need to Reduce Staff? Consider Shared Work Programs to Lessen the Pain (COVID-19 Coronavirus)

Legal Update: New York Adopts Sweeping Paid Sick Leave Law (COVID-19 Coronavirus) teaser
March 20, 2020

Legal Update: New York Adopts Sweeping Paid Sick Leave Law (COVID-19 Coronavirus)


News


November 2, 2018

Michael Bernstein Serves as Editor-in-Chief of 2018 Cumulative Supplement to Managed Care Litigation, Second Edition

Health + Benefits Litigation Team lawyer Michael H. Bernstein served as editor-in-chief of the 2018 Cumulative Supplement to Managed Care Litigation, Second Edition. Published by Bloomberg BNA and the American Bar Association Health Law Section, the book is described as an essential reference "written specifically for practitioners who handle managed care disputes to help them rapidly focus on key issues and expertly advise their clients." Among other things, the 2018 Cumulative Supplement discusses: Disputes involving: medical necessity determinations; benefit exclusions on mental health disability, autism spectrum disorder treatment, and gender dysphoria; an anti-abortion group’s challenge to the contraceptive mandate exemption; and bad faith and negligent credentialing cases; Provider versus payor issues such as line item denials of charges, and patient actions brought for charging more than payor contract rates; and Updates on pay for performance programs (P4P), Hospital Value-Based Purchasing(VBP), the Merit-based Incentive Payment System (MIPS) and Advanced APM Michael was also editor-in-chief of the 2017 Cumulative Supplement. View more information on the book.

Bloomberg BNA
October 17, 2017

Robinson+Cole Lawyers Recognized by Super Lawyers®

November 2, 2018

Michael Bernstein Serves as Editor-in-Chief of 2018 Cumulative Supplement to Managed Care Litigation, Second Edition

Health + Benefits Litigation Team lawyer Michael H. Bernstein served as editor-in-chief of the 2018 Cumulative Supplement to Managed Care Litigation, Second Edition. Published by Bloomberg BNA and the American Bar Association Health Law Section, the book is described as an essential reference "written specifically for practitioners who handle managed care disputes to help them rapidly focus on key issues and expertly advise their clients." Among other things, the 2018 Cumulative Supplement discusses: Disputes involving: medical necessity determinations; benefit exclusions on mental health disability, autism spectrum disorder treatment, and gender dysphoria; an anti-abortion group’s challenge to the contraceptive mandate exemption; and bad faith and negligent credentialing cases; Provider versus payor issues such as line item denials of charges, and patient actions brought for charging more than payor contract rates; and Updates on pay for performance programs (P4P), Hospital Value-Based Purchasing(VBP), the Merit-based Incentive Payment System (MIPS) and Advanced APM Michael was also editor-in-chief of the 2017 Cumulative Supplement. View more information on the book.

Bloomberg BNA
October 17, 2017

Robinson+Cole Lawyers Recognized by Super Lawyers®

Events


Past

Managed Care Litigation: Anti-Assignment Clauses, Reimbursement Claims, State Law Claims

Feb 26 2025
Strafford Webinar
Past

Managed Care Claims Trends

Jul 21 2023
WTW’s 2023 Healthcare Risk Conference
Past

Managed Care Litigation: Anti-Assignment Clauses, Reimbursement Claims, State Law Claims

Feb 26 2025
Strafford Webinar
Past

Managed Care Claims Trends

Jul 21 2023
WTW’s 2023 Healthcare Risk Conference
Past

Health Law Update

Apr 15 2021
DRI's "2021 Life, Health, Disability, and ERISA Virtual Seminar"
Past

Navigating Coverage Considerations for Behavioral Therapy and Substance Abuse Treatment

Jul 23 2020
American Conference Institute's 11th Annual Advanced Forum on Managed Care Disputes and Litigation
Past

Attorney Client Privilege and Work Product

May 15 2018
2018 Paralegal Conference presented by the Connecticut Chapter of the Association of Corporate Counsel
Past

Physicians vs. Health Plans

April 26-28, 2017
DRI Life, Health, Disability & ERISA Conference
Past

Health Law Update

Apr 15 2021
DRI's "2021 Life, Health, Disability, and ERISA Virtual Seminar"
Past

Navigating Coverage Considerations for Behavioral Therapy and Substance Abuse Treatment

Jul 23 2020
American Conference Institute's 11th Annual Advanced Forum on Managed Care Disputes and Litigation
Past

Attorney Client Privilege and Work Product

May 15 2018
2018 Paralegal Conference presented by the Connecticut Chapter of the Association of Corporate Counsel
Past

Physicians vs. Health Plans

April 26-28, 2017
DRI Life, Health, Disability & ERISA Conference