Tina Safi Felahi

Tina is an associate in the firm’s Consumer Financial Services practice who focuses on representation of health care providers and managed care plans in a broad spectrum of civil litigation. She represents major health plans and insurers in complex litigation in both state and federal courts, including actions for breach of contract, bad faith denial of benefits, ERISA benefits, and unfair competition, among others, with particular emphasis on out-of-network provider reimbursement disputes.

Tina also guides providers and health plans on a broad range of state and federal compliance issues, and represents health care clients in administrative proceedings.

• ABC Services Group, Inc. v. Health Net of California, Inc., et. al., 8:19-cv-00243-DOC (C.D. Cal. June 13, 2022) – Obtained dismissal with prejudice of litigation against Anthem Blue Cross Life and Health Insurance Company, Anthem, Inc., Beacon Health Options, Inc., Beacon Health Strategies, LLC, ValueOptions Federal Services, Inc., and ValueOptions of California, Inc. The plaintiff sought to recover claims on behalf of a closed substance abuse treatment facility. The litigation was initially filed as individual lawsuits in state and federal court against 36 defendants, asserting state law and ERISA claims. The litigation was consolidated in the U.S. District Court for the Central District of California, which granted the defendants’ motion to dismiss the plaintiff’s first amended complaint. On appeal, the Ninth Circuit Court of Appeals affirmed the dismissal of the state law claims and remanded the ERISA claims to the district court, which dismissed the remaining ERISA claims for lack of standing and failure to cite specific plans and plan terms.
• Successfully represented Blue Cross Blue Shield of Georgia, Inc. (dba Anthem Blue Cross Blue Shield) in an ERISA § 1132(a) matter in the Central District of California. The plaintiff alleged Anthem improperly denied benefits relating to Proton Beam Radiation Therapy (PBRT) to treat his prostate cancer. The court confirmed that records evidenced Anthem’s reasonable review and proper reliance on its medical policies, guidelines, and literature, as required by the health benefits plan at issue, in denying the benefits at issue. The court further held that Anthem’s determination that the plaintiff’s PBRT treatment was not covered by the plan was not an abuse of discretion. As such, the court entered judgment in Anthem’s favor. Loren Swearingen v. Westlake Health Care Plan, et. al., 2:20-cv-02052-MCS-JEM (C.D. Cal. August 24, 2021).

• Best Lawyers in America®: Ones to Watch: Banking and Finance Law (2021-2026); Litigation – Banking and Finance (2023-2026)