An arbitrator with extensive experience in healthcare reimbursement cases, including payor–provider and appellate matters, Sam Hanson serves on the AAA Healthcare Panel, guiding complex dispute resolution.
With this breadth of experience, we asked him about his background and approach to healthcare arbitration.
Q: Tell us about your background in healthcare law and handling healthcare-related cases.
Sam: Starting in about 2021, I was appointed as an arbitrator to my first healthcare reimbursement case. Around that same time, I joined the AAA Healthcare Roster and have since been appointed in about 20 healthcare cases.
Q: What types of healthcare disputes do you typically handle as an arbitrator or mediator?
Sam: The majority of my cases involve reimbursement disputes between providers and payors—claims by pharmacies, physician groups, and hospitals. Only one of my matters has gone to hearing, involving whether an insurer’s incentive program was properly applied to a specialty pharmacy providing high-level cancer treatment, including issues under the 340B program. I’ve also handled appeals, including a significant matter involving 36 hospitals and the question of how to assess usual and customary charges for emergency services.
Q: What drew you to ADR work in the healthcare space? What do you value most about serving as a neutral on the AAA’s Healthcare Panel?
Sam: I value the opportunity to resolve disputes in a fair, efficient manner, particularly where the stakes are high for both providers and insurers. These cases often raise important systemic questions about how healthcare is delivered and paid for, and it’s rewarding to contribute to outcomes that bring clarity.
Q: How has your judicial experience shaped the way you approach healthcare arbitration or mediation?
Sam: My judicial background informs the way I manage complex cases, particularly when it comes to structuring discovery and making sure that each side has a fair opportunity to present their case. Many of these disputes involve hundreds or thousands of consolidated charges, which makes protocols for sampling and data presentation critically important.
Q: Are you noticing any emerging issues or trends in healthcare cases coming to arbitration?
Sam: Yes—there is an increasing focus on the reimbursement of out-of-network providers and how to define usual and customary charges. In addition, disputes about the application of incentive programs and compliance with 340B reimbursement requirements are appearing with greater frequency.
Q: What advice do you have for parties preparing for arbitration or mediation in complex healthcare disputes?
Sam: Pay close attention to discovery and data issues. Where large volumes of claims are consolidated, parties should work together early to develop clear and fair sampling protocols. Doing so can avoid significant disputes down the line and lead to a more efficient process.