Cecilia Morgan, Esq. has gained extensive experience in health care/insurance matters over the last 38 years serving as an attorney, a mediator, and an arbitrator. She completed the American Health Lawyers Association Peer Review Officer Training in July, 2008. From the time she started practicing law in 1977, she has always had medical professionals as clients and, as such, has a working knowledge of the health care industry, practices, language, and general health laws.
She has watched the development of health information technology, HCFA, ERISA, CPT codes, superbills and batching, clean and unclean claims, claims of fraud and abuse, electronic billing, ICD9 diagnostic codes, PPACA, and the confidentiality client protection provisions of HIPPA. She has dealt with various changes in medical practice, managed care, PPOs, HMOs, health systems, home health care agencies, real estate, office leasing, business transactions, physicians', nurse practitioners', and other medical staff contracts.
She has mediated, arbitrated, or facilitated over 3,000 cases in many different areas of law in Texas and 31 other states since 1991. She regularly re-mediates litigation cases from state and federal courts.
- Co-mediated dispute between disgruntled shareholder/co-developer of medical device and the company after successful IPO
- Mediated a case between the parents of a child undergoing experimental medical treatments and the teaching hospital, the ERISA claims administrator, and the insurance company over a six-figure plus bill
- Mediated case where alleged failure by hospital to perform due diligence when hospital was being acquired by large HMO resulted in death of husband/father
- Mediated claim against hospital and nursing staff for failure to remove one of seventy surgical sponges causing infection to surgical site in Medicare patient
- Mediated credentialing and peer review dispute involving physician’s termination after hospital board determination
- Mediated many personal injury cases involving the negotiation of hospital and Medicare/Medicaid liens
- Mediated medical malpractice case on Accutane failure to warn by dermatologist where patient endured an unwanted abortion as a result
- Mediated medical malpractice case where neonatal nurses were allegedly responsible for failing to provide sufficient oxygen during delivery with resulting mental retardation
- Mediated numerous medical malpractice cases involving long-term care and life-care plans
- Mediated several cases involving the preemption provisions of ERISA
- Mediated several medical practice divorces involving covenants not to compete and labor and employment issues arising in hospitals and medical practices
- Mediated the first Texas state court case against an HMO by an individual plaintiff prior to its removal to federal court
- Mediated wrongful death claim brought by suicidal patient’s widow when HMO allegedly failed to provide mental care/psychiatric specialist care for her husband
- Mediated dispute between major hospital corporation and doctor group over use of outpatient facility
- Re-mediated business divorce of multi-million dollar ophthalmology practice
- 1998-2000, Olen Lovell, Petitioner, vs. Harris Methodist Health System, et al. Respondents, Petitioner’s Motion to vacate arbitration award denied. Olen Lovell, Petitioner vs. Harris Methodist Health System, et al., Respondents, 235 F.3d 1339 (5th Cir. (Tex.) October 16, 2000). The multi-day race and sexual preference case resulted in the arbitration award which was upheld by the referring court.
- Arbitrated a case between a hospital, an HMO, and a large multi-doctor orthopedic practice under the Texas speedy claims payment provisions
- Arbitrated a nurse’s wrongful termination claim against a major hospital; the nurse claimed national origin discrimination and the hospital claimed the nurse allegedly violated patient rights of confidentiality and care
- Arbitrated the business divorce of a gynecological medical practice with issues involving clean and unclean claims, past due bills, insurance coverage, third-party payers and vendors
- Arbitrated practice break up involving division of equipment, lease obligations and accounts receivable
- Arbitrated dispute between hospital and large multi-practice physician group over reasonable and necessary charges reported to HMO
- Arbitrated dispute between doctor acting as medical director of a satellite outpatient facility with an exclusive four year contract and major hospital group after takeover of the hospital by new investor
- Dalkon Shield Arbitrations. In 1996-1997, Ms. Morgan arbitrated over 125 cases between the Dalkon Shield Claimants Trust and individual claimants as part of the A. H. Robins Plan of Reorganization ADR plan in bankruptcy. She conducted hearings in New York, Virginia, Indiana, Louisiana, and Texas. These were high and low arbitrations with a maximum award of $20,000 per claimant and a low of zero. This ADR program required the issuance of reasoned written opinions within 20 days of the live evidentiary hearings and review of volumes of the claimants’ medical records.
- Breast Implant Settlement Facilitation. In 1995, Ms. Morgan was appointed as one of thirty individuals from across the country to present a settlement offer from several product manufacturers to claimants. The presentation, which she designed and conducted in Dallas, was subsequently used as the prototype for presentations across the country. Recognizing the highly sensitive and confidential nature of the settlement information, she was designated to deal with the news media present. After over forty presentations, she acted as the "trouble shooter" and answered questions that arose from claimants after the fact.