Steven M. Ziegler, Attorney

Steven M. Ziegler is the founding and managing partner of the Firm. He was born in Silver Spring, Maryland where he lived until earning his Bachelor of Arts degree, with honors, in Political Science from the University of Maryland in 1978. Mr. Ziegler relocated to South Florida and in 1981 he earned a Juris Doctor degree from the University of Miami School of Law, with honors.

Mr. Ziegler was one of the first attorneys in the country to specialize in representing Managed Care Organizations. Since 1981, Mr. Ziegler has been providing full-scale legal services to Managed Care Organizations nationwide. These services include the representation in litigation and administrative matters in which he has defended Managed Care Organizations in literally hundreds of cases involving professional liability, benefit disputes, contract disputes, class actions, anti-trust, ERISA, Medicare and Medicaid issues, and regulatory actions. In addition, Mr. Ziegler provides counsel to the Firm's clients on contract and corporate matters including the drafting and structuring of contracts, formulating policies and procedures, legislative matters, and risk management advice.

Mr. Ziegler's vast experience in all aspects of a managed care organization allowed him to become an innovator of many of the managed care organization defenses to matters based on numerous liability theories, such as vicarious liability for the actions of health care providers, negligent credentialing of participating health care providers, non-delegable duty for the actions of health care providers, direct negligence for utilization management functions, direct negligence based on case management, and direct negligence based on concurrent review. Mr. Ziegler has also been an innovator in the managed care industry in developing methods to successfully defend disputes with subscribers over medical benefits, payment of premiums, continuation of coverage under COBRA, conversion of policies, and rescission.

Mr. Ziegler's expertise and vast experience in the healthcare and insurance industries has also allowed him to be a leader in successfully developing defense models for managed care organizations in litigation involving claims for bad faith, fraud, fraud in the inducement, intentional infliction of emotional distress, negligent infliction of emotional distress, breach of fiduciary duty and breach of covenant of good faith and fair dealing. Mr. Ziegler's vast knowledge in the area has also allowed him to represent managed care clients in disputes to identify and pursue external fraud and abuse.

Mr. Ziegler drafted the 2003 HMO Tort Reform legislation in Florida, limiting vicarious liability claims against managed care organizations based on the alleged negligence of contracted providers. Since its passage, this legislation has had a significant impact on curtailing managed care liability in the State of Florida.

Considered one of the leading attorneys in the nation in the fields of healthcare and insurance, Mr. Ziegler is a frequent lecturer and author on managed care liability and regularly conducts numerous seminars nationwide for managed care organizations, in-house counsel, insurers, and medical providers. Examples of the seminars that Mr. Ziegler has conducted are:

• Managed Care Liability Issues: Past, Present and Future presented at the PLUS National Medical Professional Liability Symposium
• Emerging Trends in Managed Care Litigation and How a Claim Affects a Health Plan: Before, During & After presented at Amerigroup Health Plan
• Arbitration and Dispute Resolution - Payor and Provider Perspectives presented at the American Health Lawyers Association Managed Care Law Institute
• Provider/Payor Disputes Over the Payment Methodology of Usual, Customary and Reasonable Charges; Liability Issues Related to Medicare Advantage Plans; Rescission Law Update presented at the Annual Marsh Health Care Forum
• Emerging Liability Trends in Provider/Payor Disputes and Arbitration - Panacea or Pandora's Box presented at the IPA Association of America's Annual National Conference in Las Vegas, Nevada
• Willis Group Annual Managed Care Meeting in Las Vegas, Nevada entitled New Theories of Law in MCO Cases and Ways to Reduce and Limit Risk
• Emerging Liability Trends in Provider/Payor Disputes presented at the AIG Healthcare Forum on From Provider Disputes to Class Action Lawsuits: Understanding Emerging Risks and How to Minimize Their Impact
• Impact of the Florida HMO and Tort Reform presented at the Florida Association of Health Plans Annual Meeting
• HMO Reform in Florida presented at the Annual Marsh Healthcare Forum
• Liability Exposure & Reduction of Risk presented to the Senior Staff and Medical Directors at Blue Cross and Blue Shield of Florida, Inc.
• Health Plan Tort Liability presented to Blue Cross and Blue Shield Annual Lawyers Conference
• Legal Issues in Complex Case Management presented to AvMed Health Plan
• Practicing Medicine in a Managed Care Environment presented to Sheridan Health Corporation
• Liability Issues Facing Managed Care Organizations and Their Affiliated Providers presented to Blue Cross and Blue Shield of Florida, Inc.
• Ever Expanding Exposures in Managed Care presented to Florida Society for Health Care Risk Managers
• Criminalization of Managed Care presented at Annual Managed Care Conference, Lexington Insurance Company
• Defense Strategies for Managed Care presented to Resource Developments, Inc.'s Professional Liability Series
• Defense Strategies for Managed Care Claims presented to Medical Malpractice JUA National Symposium
• Managed Care Liability and Privacy Issues presented at CIGNA/MCC/Intracorp Annual Conference
• Classic Managed Care Case presented Mock Trial at Annual Managed Care Conference, Lexington Insurance Company

Examples of the articles that Mr. Ziegler has authored or has been featured in are:

• Medical Tourism: A Risky Business?, published by the American Health Lawyers Association in the August 2009 Issue of the Payors Plans & Managed Care Newsletter
• Managed Care Under Seige, published by Managed Care Magazine in February 2009
• Look Before You Leap: Points to Ponder Before Including an Arbitration Clause in Your Contract, published by the American Health Lawyers Association in the January 2009 Issue of the Payors Plans & Managed Care Newsletter

In 2006, Mr. Ziegler was appointed National Managed Care Counsel for Lexington Insurance Company, a division of AIG Healthcare, the leading insurer of Managed Care Organizations in the nation. This appointment is a culmination of work performed by Mr. Ziegler in partnership with Lexington Insurance Company to find new and better ways to serve managed care clients. In 1996, Mr. Ziegler in partnership with Lexington Insurance Company established a risk management program for managed care clients nationwide to advise and assist them in reducing their liability exposure. The risk management program encompasses the review and assessment of service contracts, provider contracts, member contracts, group contracts, marketing materials, departmental policies and procedures, organizational policies and procedures, organizational guidelines, provider guidelines, credentialing policies and procedures, utilization management policies and procedures, concurrent review policies and procedures, provider compensation guidelines, and provider incentive guidelines, among others. The Firm's partnership with Lexington Insurance Company will also now be expanded nationwide to include defense of claims, pre-claim assistance and on-site risk management for healthcare and managed care organizations insured through Lexington Insurance Company.

Mr. Ziegler is admitted to the Florida Bar, the District of Columbia Bar and the New York Bar. In addition to practicing in all state and federal courts in Florida, he also practices in Florida's appellate courts, the Supreme Court of Florida and in the Eleventh Circuit Court of Appeals. He is a member of the Health Law and Trial Lawyers Sections of the Florida Bar, the American Bar Association (Health Law Section and Managed Care and Insurance Interest Group), the American Health Lawyers Association (Payors, Plans and Managed Care Section and Medical Staff, Credentialing and Peer Review Section), the American Health Lawyers Association, the American Association of Health Plans, the National Defense Lawyers Association and the Florida Defense Lawyers Association. He has received an AV rating from Martindale-Hubbell, the highest rating an attorney can obtain, which is based on confidential questionnaires.