John C. West

John is competitive and invested in the best outcome for his clients. He is always composed and confident in his skills to solve problems.

John West is a partner in Lewis Roca’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. He also represents Fortune 500 companies and other business clients in commercial contract disputes, class action, and business litigation matters. 

In his more than 40 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. 

Personal Approach

John is a strategic thinker and a highly competitive lawyer. He brings a diverse range of industry experience to his practice and strives to secure wins and provides the best results possible for his clients.

John is an avid college football fan, long-time follower of Formula One racing, loves music, travel, and is a devoted family man.

More About John C. West

Education

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

Bar Admissions

• Arizona, 1982
• Ohio, 1979 (inactive)

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, District of Arizona
• U.S. District Court, District of Colorado
• U.S. District Court, District of New Mexico
• U.S. District Court, Northern District of Ohio

Community

• American Health Lawyers Association
• Arizona Association of Health Care Lawyers
• 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 lawyers' 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.

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