John C. West

John C. West

Partner
jwest@lrrc.com vCard
602.262.5781 office
602.262.5747 fax
201 East Washington Street
Suite 1200
Phoenix, AZ 85004

Overview

John C. West is a partner in Lewis Roca Rothgerber Christie’s Litigation practice group.

John is a top resource for industry leading health care entities who are dominant players in the national health care arena.  His representation includes managed care organizations, health plans, provider networks, group health insurers, self-funded and insured employee benefit plans and payor entities in a wide spectrum of complex health law related matters.  John also represents Fortune 500 companies and other business clients in commercial contract disputes, class action and business litigation matters. 

In his 35 years of experience, John has counseled clients and litigated matters involving network contracting disputes, provider reimbursement and overpayment recovery, ERISA benefits litigation, Medicare benefits and related issues.  John also has substantial experience representing Medicare Advantage Organizations in regulatory and litigation matters including provider reimbursement issues, network compliance, termination, member steering, overpayments and fraud recovery. 

A seasoned litigator, John has handled numerous hearings in state and federal courts and numerous arbitrations, administrative hearings, and appeals before the Medicare Appeals Council.  John has successfully defended health plans in jury trials in first party breach of bad faith actions. 

John is counsel of record in numerous reported decisions that have established important precedent including Spinedex Physical Therapy v. United Healthcare of Arizona, 770 F.3d 1282 (9th Cir. 2014) (ERISA Article III standing, assignment of breach of fiduciary claims, enforcement of anti-assignment provision); United Behavioral Health v. Maricopa Integrated Health System, 377 P.3d 315 (Ariz. 2016) (non-arbitrability of patients’ Medicare and ERISA benefits claims by provider); Parra v. PacifiCare of Arizona, Inc., 715 F.3d 1146 (9th Cir. 2013) (MA Plan standing under Medicare Secondary Payer Act); and Arizona Department of Administration v. Cox, 213 P.2d 707 (Ariz. App. 2009) (establishing State’s third party recovery rights).

John is a recognized practitioner by Chambers USA and has been included in Best Lawyers of America in the categories of health care law and commercial litigation since 2005.

Memberships & Affiliations

  • American Health Lawyers Association
  • Arizona Association of Health Care Lawyers
  • American Bar Association
  • Maricopa County Bar Association
  • Arizona Bar Foundation
  • Arizona Science Center, Board of Trustees, 2009-present
  • Arizona Equal Justice Foundation, Board of Directors, 2008-2010
  • Arizona State University Technopolis, Advisory Board, Member, 2005

Representative Matters

  • Representation of health plans in actions for recovery of overpayments to providers, having secured arbitration awards and settlements under ERISA and common law theories of recovery.
  • Representation of health plans in defense of actions by non-contracted providers for payment of out of network claims denied due to provider waiving of patient cost share responsibility (copayments and deductibles), billing fraud and coverage issues.
  • Representation of health plans and plan administrators in numerous actions brought by providers under ERISA § 502 for the recovery of plan benefits, including actions for payment of out of network claims as network benefits, disability, behavioral health, and claims related to emergency air transportation.
  • Representation of ERISA, Medicare and State plans in enforcement of plan subrogation and reimbursement rights over third party recoveries.
  • Counsel for claims administrator and numerous employer sponsored health plans in putative class action brought by chiropractor and plan participants for reimbursement of treatment denied as “experimental and unproven” addressing issues relating to Article III standing, assignment of breach of fiduciary duty claims, exhaustion, enforceability of plan limitation periods, and purported ERISA violations.
  • Counsel for health plan in defense of provider contract claim arising out the allocation of taxes under the Affordable Care Act.
  • Counsel for behavioral health plan in successful action to block arbitration of multiple individual benefit claims under provider contract’s arbitration provision that were, at bottom, coverage denials and subject to mandatory Medicare administrative procedure.
  • Counsel for health plan in arbitration on issue whether Medicare based reimbursement under MA Plan includes capital costs for “new hospitals” when paid on a cost basis and not prospectively under IPPS Pricer.
  • Counsel for health plan in arbitration award denying provider’s claim for $25 million in damages for alleged improper network termination.
  • Counsel for health plan in successful defense of putative class action for improper termination of Medicare Advantage product within service area.
  • Counsel for health plan in putative class actions alleging wrongful rescission of class members individual policies for purported failure to comply with Arizona law.
  • Counsel for health plan in defeating class certification for alleged misrepresentation in the sale of individual plans as group plans and alleged failure to disclose fees.
  • Counsel for self-funded ERISA plan in recovery against stop loss carrier that contested the ERISA plan administrator’s eligibility determination.
  • Counsel for health plans in defense of actions brought under False Claims Act.

Trials

  • Successful defense of health insurer in eight day jury trial in which plaintiff claimed breach of contract and insurance bad faith in insurer’s denial of coverage of narcotic pain medications over a six year period.  The plaintiff sought compensatory and bad faith damages exceeding seven figures.  Unanimous defense verdict.  Court awarded health insurer $350,000 in attorneys’ fees. 
  • Successful defense of MA Plan in jury trial brought by MA plan member seeking compensatory and punitive damages claiming that placement in lower level of care caused physical injury and was in breach of duty of good faith and fair dealing.
  • Defended MA Plan in a seven-week jury trial brought by survivors of a deceased member claiming the plan intentionally delayed acceptance of the member into a facility in order to shift financial responsibility to a capitated provider group (settled in week seven).

Administrative

  • Representation of Medicare Advantage plans in benefit actions before Administrative Law Judge and Medicare Appeals Council.
  • Representation of health plan in successful bid protest over state funded health plan leading to contract award covering 100,000 participants.

Related News

8/15/2017
Partners honored as Lawyer of the Year by Best Lawyers
85 Lewis Roca Rothgerber Christie attorneys in The Best Lawyers in America 2018
05/31/2017
Attorneys, practices earn recognition in Chambers USA 2017
Rankings reflect research findings based on client and peer feedback
08/15/2016
83 Lewis Roca Rothgerber Christie attorneys named in ‘Best Lawyers'
11 partners also honored as ‘Lawyer of the Year' in The Best Lawyers in America® 2017
05/27/2016
Chambers USA recognizes Lewis Roca Rothgerber Christie attorneys
Annual rankings reflect law firm's focus on client service, value, commitment to excellence
11/04/2015
Lewis Roca Rothgerber lands key health care litigators West, Kort
John C. West, Robert M. Kort added as partners in Phoenix office of growing general practice firm

Publications

  • Author, "The Continuing Expansion of Parity of Mental Health Benefits," Arizona Capitol Times, November 2015

Distinctions

  • Chambers USA - Recognized Practitioner, 2015-2017
  • Martindale-Hubbell - "AV/Preeminent Attorney" Rating
  • The Best Lawyers in America - Woodward/White, Aiken S.C. - Healthcare Law, Commercial Litigation, 2005-2017
  • Southwest Super Lawyers - Healthcare Law, 2007-2017
  • Arizona Business Magazine - Top 100 Lawyers, 2015
  • Phoenix Business Journal - Best of the Bar
  • Arizona's Finest Lawyers

Other Info

Education

J.D., Ohio Northern University, Pettit College of Law, 1979
B.A., Ohio Northern University, 1976, History

Bar Admissions

Arizona, 1982
Ohio, 1979

Court Admissions

Arizona Supreme Court
Ohio Supreme Court
U.S. Court of Appeals, Ninth Circuit
U.S. Court of Appeals, Tenth Circuit
U.S. District Court for the District of Arizona
U.S. District Court, Colorado
U.S. District Court, New Mexico
U.S. District Court, Northern District of Ohio