David E. Loder is chair of the firm's Health Law Practice Group. He focuses his practice on hospital governance, accreditation, credentialing, litigation of reimbursement issues, managed care arrangements and Medicaid and Medicare programs. He represents numerous for-profit and nonprofit organizations in the healthcare industry.
Mr. Loder serves as general counsel to the Hospital and Healthsystem Association of Pennsylvania. He is also general counsel to Health Partners of Philadelphia, a leading provider of healthcare services to the Medicaid and Medicare populations, and to the Pennsylvania Trauma Systems Foundation, an organization that establishes standards and accredits trauma centers in the commonwealth of Pennsylvania.
He is a member of the American, Pennsylvania and Philadelphia Bar associations and a graduate of the London School of Economics (LL.M., international law, 1982), the University of Pennsylvania Law School (J.D. 1981) and Wesleyan University (B.A. 1977).
Areas of Practice
· Healthcare Law
· Nonprofit Institutions
· Employment Law
· Education Law
· Obtained on behalf of the Hospital and Healthsystem Association of Pennsylvania (HAP) a ruling from the Commonwealth Court of Pennsylvania that held that the Pennsylvania Insurance Department had overbilled health care providers more than $100 million over three years to fund a program that provides excess coverage for medical malpractice claims under the state's Medical Care Availability and Reduction of Error Act (MCARE).
· Represented The Hospital & Healthsystem Association of Pennsylvania (HAP) against the Pennsylvania Department of Public Welfare and Office of the Budget in a dispute over funding physician abatements related to the Commonwealth's medical liability insurance fund (MCARE). HAP alleged that the Commonwealth failed to transfer between $465-$616 million from the Health Care Provider Retention Account to MCARE to fund the abatements granted to healthcare providers from 2003 to 2007. In an en banc decision rendered on April 15, 2010, the Commonwealth Court of Pennsylvania ruled that the Commonwealth defendants had a statutory obligation to fully fund the abatements and were obligated to transfer funds to the Health Care Provider Retention Account. In a related decision entered the same day, the Commonwealth Court ruled that the transfer of $100 million from the MCARE fund to the Commonwealth's General Fund was also improper.
· Closed a $100 million line of credit transaction for our client, a Medicaid HMO servicing more than 160,000 members under the Pennsylvania HealthChoices program.
· Represented Health Partners of Philadelphia in the $160 million sale of its Medicare product to Bravo Health obtaining the approval of the Philadelphia Orphans Court.
· Represented Chester County Hospital in major antitrust litigation against Independence Blue Cross involving monopoly and monopsony claims.
· Represented more than 20 Pennsylvania healthcare systems, comprising roughly 100 healthcare providers, in an action against the PA. Dept. of Public Welfare to obtain recovery on more than $60 million in claims owed the providers by an insolvent Medicaid HMO. Settled with the PA Department of Public Welfare for $10 million and the PA Insurance Department for over $20 million through a unique arrangement to avoid claim-by-claim review and shorten the liquidation process--with the approval of the Commonwealth Court.
· Ongoing advice and counsel to CEOs, Boards and executives of major regional health care and not-for-profit institutions.
· General Counsel, Hospital and Health System Association of Pennsylvania
· General Counsel, Health Partners of Philadelphia
· General Counsel, Pennsylvania Trauma Systems Foundation
· Co-trustee, Dolfinger-McMahon Foundation
· Co-trustee, Lindback Foundation
· Duane Morris LLP
- Chair, Health Law Practice Group, 2008-present
- Co-chair, Health Law Practice Group, 2000-2008
- Member, Partners Board, 1999-present
- Partner, 1989-present
- Associate, 1982-1988
· Pennsylvania Bar Association
· American Bar Association
· Philadelphia Bar Association
Honors and Awards
· Listed as one of Philadelphia's 2014 Top Rated Lawyers by Martindale-Hubbell
· Listed as a Top Rated Lawyer in Healthcare by American Lawyer Media and Martindale-Hubbell, 2013
· Listed in The Best Lawyers in America
· AV® Preeminent™ Peer Review Rated by Martindale-Hubbell
· University of the Sciences in Philadelphia (formerly Philadelphia College of Pharmacy and Science), 1998-present
· Preventive Medical Technology, 1997-present
· World Affairs Council of Philadelphia, 1996-2004
· ABRAXAS Foundation, Inc., 1990-1997
· Wilma Theater
- Executive Committee Member, 2001 - present
· Strings for Schools, 1989-1991
Civic and Charitable Activities
· Philadelphia Mayoral Team, Health Care Industry Subcommittee, 2000
· Co-chair, Delivery System Restructuring Transition Work Group, 2000
· Big Brothers Association
· Co-chairperson, Germantown Friends School Alumni Giving, 1991-1993
· Class Agent, University of Pennsylvania Law School, 1984-present
· Advisory Council Member, "Non-Profits at the Millennium", Philadelphia Health Management Corporation
· Co-author, "Old Confusions Back for Charitable Property Tax Exemptions," Pennsylvania CPA Journal, Fall 2012
· Co-author, "When Does the Payment of Low Reimbursement Rates or Other Conduct by an Insurer Violate the Antitrust Laws?," Duane Morris Alert, December 6, 2010
· Co-author, "Healthcare Reform-Some Key Business Opportunities Every Hospital CEO Should Know," Modern Healthcare, April 2010
· Author, "When Do 'Reasonable Accommodations' Unreasonably Compromise Patient Care?" Modern Healthcare Magazine, Special Supplement, 2007
· Co-author, " In Gestational Surrogacies All Parties Must Bear Risk," The National Law Journal, September 9, 1996; Trial: A Journal of the Association of Trial Lawyers of America, August 1997
· Co-author, "COBRA v. Managed Care: A Dilemma for Hospitals," The Legal Intelligencer, December 14, 1995
· Co-author, "Hospitals in Code-Blue Catch-22," The National Law Journal, September 18, 1995
· Author, "Infectious and Chemotherapeutic Waste", Pennsylvania Environmental Law - Federal Publications, Inc., October 1990
· Co-author, "Is HMO Exempt Status Becoming a "Hot" Issue? - Recent Status Revocation and IRS Business Plan Signal Future Attention," Health Care Law Monthly, July 1999.
Selected Speaking Engagements
· Speaker, "Act 55 Update: Meeting Tax-Exempt Responsibilities in Pennsylvania," Hospital & Healthsystem Association of Pennsylvania, July 18, 2012
· Interviewed on Executive Leaders Radio, March 20, 2010
· "Medical Liability Reform, CAT Fund Reform and Patient Safety Satellite Broadcast," Philadelphia Bar Institute, Harrisburg, Pennsylvania, April 2002
· "Tort Reform - A Teetering Three Legged Stool," Philadelphia Association of Defense Counsel, Philadelphia, Pennsylvania, May 21, 2002
· "Is It Confidential? The Scope of Peer Review Protection for Trauma Data and Information," Pennsylvania Trauma Systems Foundation, November 1, 2001
· "Update...Confidentiality of Medical Records," Philadelphia, Pennsylvania, September 1996; Lancaster, Pennsylvania, March 1997; Cherry Hill, New Jersey, April 1999
· "HealthChoices Contracting With DPW," Delaware Valley Healthcare Council of The Hospital & Healthsystem Association of Pennsylvania Symposium, March 1999
· "The Year in Non-Profit Healthcare Law," Delaware Valley Healthcare Council of HAP Symposium, Philadelphia, Pennsylvania, December 1998
· "Gestational Surrogacies," Pennsylvania Society of Health Care Attorneys and Pennsylvania Bar Institute sponsored, Pittsburgh, Pennsylvania, February 1997
· "Current Challenges Facing Not for Profit Organizations," Schultz & Williams sponsored seminar, June 1996
· "Current Developments in Medicaid Managed Care," Pennsylvania Bar Institute, November 1995
· "Recent Developments in Reproductive Technology," University of Pennsylvania Law School, October 1995
· "Legal Issues Relating to Healthcare Reimbursement," Medical College of Pennsylvania, February 1993