Mitchell Zamoff brings extensive experience in resolving disputes involving healthcare entities and health law. He has been deeply engaged in healthcare dispute resolution throughout his career, including his roles as a partner at Hogan Lovells—representing clients across the healthcare industry—and as General Counsel of UnitedHealth Group. Mitchell has served on the AAA Board of Directors and its Healthcare Advisory Council, and he trains former judges seeking to join AAA’s healthcare panel. He has arbitrated or mediated more than 200 cases.
With a blend of experience as a healthcare litigator, and longtime AAA neutral, Mitchell brings deep, practical insight to resolving complex healthcare disputes. We asked him how this unique perspective shapes his approach on the AAA Healthcare Panel.
Q: Tell us about your background in healthcare law or the healthcare industry.
Mitchell: As a partner at Hogan Lovells, I represented clients across the healthcare industry in ADR proceedings, civil litigation, and government investigations. My clients included healthcare providers, health associations, insurers, third-party administrators (TPAs), medical device manufacturers, pharmaceutical and biotech companies, pharmacy benefit managers (PBMs), laboratory services providers, and health consulting and technology firms.
As General Counsel of UnitedHealth Group, I oversaw the dispute resolution portfolio for both its health insurance and health services businesses.
As a neutral, I have devoted a substantial portion of my work to healthcare-related matters, alongside other complex commercial disputes. As a member of the AAA Healthcare Advisory Council, I advised on the development of the payor-provider rules and other key aspects of healthcare dispute resolution. I also regularly present at conferences and training programs focused on the intersection of health law and dispute resolution.
Q: What types of healthcare disputes do you typically handle as an arbitrator or mediator?
Mitchell: I handle a broad range of disputes between healthcare entities, often involving complex contract interpretation and federal and state healthcare laws. Parties have included health insurers, hospitals and health systems, physicians and medical groups, revenue cycle management organizations, pharmaceutical and biotech companies, medical device manufacturers, TPAs, testing and treatment facilities, PBMs, and other healthcare service providers.
These arbitrations have addressed issues such as utilization management, medical necessity, coordination of benefits, fee schedule interpretation, allowed amounts, covered services, eligible expenses, negotiated rates, clean claims, coding, prior authorization, experimental treatments and therapies, network terminations, “usual and customary” rates, HIPAA, the False Claims Act (FCA), the Affordable Care Act (ACA), ERISA, out-of-network claims, the federal 340B drug pricing program, non-compete agreements, software and outsourcing contracts, ASO agreements, partnership and joint venture disputes, unfair competition, and a wide range of alleged contractual breaches related to healthcare coverage and service delivery.
Specific matters have included payor-provider payment disputes (including claims sampling), allegations of non-compliance with healthcare laws and regulations, PBM pricing and reimbursement issues, bid protests tied to state Medicare and Medicaid contracts, disputes between health plans and TPAs or vendors, revenue cycle management claims, pharmaceutical pricing and marketing disputes, and conflicts involving joint ventures, network participation, inducements, referrals, and relationships between providers and pharmaceutical or medical device companies. I have also handled disputes involving antitrust, intellectual property, and consumer protection claims in the healthcare sector.
In addition to payor-provider matters, I have resolved numerous other healthcare contract disputes, including agreements between health plans and PBMs, TPAs, vendors, employees, contractors, joint venture partners, and pharmacies.
Q: What drew you to ADR work in the healthcare space?
Mitchell: Having experienced health law from virtually every angle, I am well-positioned to help resolve disputes between healthcare entities. I excel at cutting through industry jargon and contractual complexity to quickly get to the core of a dispute. With a strong understanding of both the business and legal concerns that often drive healthcare conflicts, I approach my role as a neutral with diligence and respect for the parties’ underlying interests.
Q: What do you value most about serving as a neutral on the AAA’s Healthcare Panel?
Mitchell: The opportunity to engage with important, complex issues alongside an impressive and highly capable group of lawyers, party representatives, and fellow neutrals.
Q: What advice do you have for parties preparing for arbitration or mediation in complex healthcare disputes?
Mitchell: Don’t default reflexively to litigation protocols. Instead, leverage the flexibility of the arbitral forum and the expertise of your arbitrator(s) to design creative, efficient, and streamlined processes tailored to your dispute.