300 S. Grand Avenue, Suite 2600
Phone: (213) 687-6742
Fax: (213) 341-6742
Karen Palmersheim has broad experience in representing health care, insurance and other corporate clients in litigation, regulatory and other business matters in the Los Angeles office. She has litigated commercial contract, business, entertainment, health care, insurance, real estate, construction, toxic tort, unfair business practices, class action, discrimination and employment cases, and has tried cases in both federal and state courts and in arbitration. She also advises clients on contract, risk-management, regulatory, and insurance coverage matters.
Ms. Palmersheim participated in the Trial Advocacy Program through the Los Angeles County Bar Association in 1998, and prosecuted criminal misdemeanor trials for the Van Nuys City Attorney's office. She is a faculty member for the Deposition Skills course offered by the National Institute for Trial Advocacy (NITA) for practicing lawyers. She is a member of the Board of Directors for the Barlow Respiratory Hospital Foundation, a member of the board of directors for the Pasadena Tournament of Roses Foundation, a Foundation Associate of the Women Business Leaders of the U.S. Health Care Industry Foundation, and a member of the Pasadena Tournament of Roses Association. She publishes health care law legal updates for the California State Bar Health Care Committee (on which she also serves), as well as for the Payors, Plans and Managed Care Committee of the American Health Lawyers Association.
Ms. Palmersheim also counsels clients on Medicare Secondary Payer issues and compliance with reporting obligations under the Section 111 MMSEA (“Medicare, Medicaid and SCHIP Extension Act of 2007”).
Ms. Palmersheim also leads the Firm's California Business Development Initiative for the Los Angeles, Sacramento and San Francisco offices, and is a member of the Firm's Practice Development Committee.
Ms. Palmersheim has broad experience in litigating specific health care related issues for her health care clients (both payors and providers), including health plans, hospitals, physician groups, skilled nursing facilities, federally qualified health centers, and other businesses subject to regulation.
She has represented clients on a variety of issues involving contract interpretation, such as issues involving termination provisions, continuity of care, risk sharing agreements, recoupment, material change, post-stabilization notification requirements, timely filing provisions, reciprocity provisions, eligibility, authorization, Medicare secondary payer rules, coordination of benefits, interpretation of division of financial responsibility agreements in capitation agreements, false claims, unfair competition under California Business and Professions Code section 17200, and specific reimbursement issues involving stop loss, invoices, implants, case rates, disallowed charges, medical bill review, out-of-network issues, pre-admission charges, level of care, and coding, as well as member-related issues including eligibility, coverage, statutory mandates, “bad faith” and elder abuse.
Ms. Palmersheim represents clients with issues of compliance with the California Knox-Keene Health Care Service Plan (HMO) Act, the California Insurance Code, and Medicare. She assists health plans in responding to regulatory investigations and enforcement matters, and with the regulatory appeals process involving both providers and enrollees. She also helps health plans with regulatory filings, such as Knox-Keene applications and compliance with timely access regulations. Ms. Palmersheim is actively involved with the California Association of Health Plans and regularly participates in industry conferences and the Legal and Regulatory Affairs Committee with health plan representatives.
Ms. Palmersheim has both prosecuted and defended cases for clients (including Fortune 500 companies) in many areas of industry, involving a wide range of issues. Some examples include representation of: a shoe manufacturer in an international distributor dispute, a hotel chain in “guaranteed reservation” litigation, producers in entertainment contract disputes, landlords in landlord/tenet disputes, contractors and subcontractors in construction defect disputes, business owners in sales and purchasing disputes, a real estate broker in a misrepresentation case, an automobile dealership in an eminent domain dispute, and a law school in contractor and educational claims litigation. Ms. Palmersheim also represents employers in employment disputes, such as wage and hour class actions, age and sexual discrimination, and wrongful termination. She has also handled “SLAPP” actions and obtained (or defended against) temporary restraining orders and injunctions when her clients needed immediate relief.
Ms. Palmersheim has defended insurance carriers in breach of contract and “bad faith” actions brought by policyholders involving numerous coverage and claims processing issues. She has helped clients obtain multiple motions for summary judgment filed in state and federal courts involving first party breach of contract and “bad faith” claims arising under both property and commercial liability policies. Many of those cases involved sophisticated issues such as efficient proximate cause, pollution exclusions or scope of advertising injury coverage, as well as various claims handling issues. She represented insured clients in a variety of matters, including catastrophic personal injury, premises liability (negligent security/criminal acts), malicious prosecution, trade secret and legal malpractice cases. Ms. Palmersheim has helped clients at trial through pretrial motion punitive damages and claims dismissals, and defense judgments through jury verdict or Judgment as a Matter of Law prior to verdict.
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