Primary Care Attorney

Primary Care Attorney

Los Angeles Daily Journal
June 7, 2010

Jonathan Gluck left the world of big law for big medicine as the general counsel of the Heritage Provider Network.

Jonathon Gluck, who since February 2008 has led the legal department for one of the state's largest physician groups, woke up one day and realized he had become a health lawyer almost without noticing. Although it was no accident - he loves the work, it wasn't exactly planned either. In just a few years, he went from handling one case for Heritage Provider Network as a litigator at Bingham McCutchen to having a practice that was more than 50 percent comprised of Heritage's health care litigation.

Heritage, a managed care company based in Torrance, also has seen a boom in its business. The company contracts with thousands of physicians to provide the gamut of medical services for hundreds of thousands of HMO members. As a full-risk physician group, Heritage has the tricky task of not just providing whatever care the insurers will cover as well as managing patients and keeping them healthy.

Last year, Heritage more than doubled its reach by acquiring an ailing San Fernando Valley medical group. It now runs medical groups practicing in nine counties, from Tulare to San Diego, with a particularly large presence around Palm Springs, Bakersfield, Burbank and Glendale. With that increase in doctors - and the patients they treat - Heritage's contractual issues and litigation have grown, too.

Now, the company is preparing to ride a new wave of interest in their model of managed care set in motion by national health care reform.

A one-time big firm lawyer who worked several years at Rirodan McKenzie and then Altshuler Grossman, Gluck said he prefers running his three-person legal department. Not only that, he much prefers hiring small firm lawyers.

Gluck spoke recently with Staff Writer Evan George. Here's an edited version of what he had to say:

DJ: How would you describe Heritage's core business?

GLUCK: Heritage is responsible for providing all the medical care for a given HMO membership. When a person signs up for an HMO they choose a primary care doctor; those doctors are typically affiliated with large groups called Independent Physician Associations, or IPAs. The HMO will provide a set amount of money to the IPA to provide health care for that member. There are two types of IPAs: shared risk and full-risk. The full-risk entities are responsible for the institutional and professional care of the member. We are one of just a few full-risk IPAs in the state of California.

DJ: What firms do you tap for certain expertise and why?

GLUCK: I give a lot of work to Mike Amir at Doll, Amir & Eley, who does most of our litigation work. I use the Miller Health Law Group for regulatory matters. Jeremy Miller has been doing this for many years. We've used Ervin Cohen & Jessup for mergers and acquisition work - they have a lot of health care experience. And Bingham McCutchen, when there is high-stakes litigation. For the larger claims cases, we use Locke Lord & Bissel & Lidell. They have to have the expertise. The health care bar is not that big. Everybody pretty much knows who's an expert in what area. Especially on regulatory stuff, I don't want to hire someone who has to start from square one on figuring out what the answer is. Reputation and cost effectiveness, and how pleasant you are to work with go into the mix too.

DJ: How have firms' increased rates impacted the company's outside litigation?

GLUCK: It makes it far more likely I'm going to try to find someone with expertise who does not work at a big firm, and I say that coming from a big firm and understanding the model. A lot of the time it's cost prohibitive, especially using junior lawyers who are billing at extremely high rates for things I can have very seasoned lawyers do at a smaller firm for a much cheaper price. That's a no-brainer.