Sam Blackmar brings healthcare industry expertise and litigation experience to Nelson Hardiman. Sam has represented physicians, healthcare facilities, physicians’ associations and hospital systems in reimbursement arbitration and litigation in state and federal courts. Sam has also advised behavioral healthcare providers on a wide range of topics including regulatory compliance, revenue cycle management, and payor disputes.
Before and during law school, Sam worked in the behavioral health reimbursement industry where he guided mental health and addiction treatment facilities through a broad range of reimbursement-related issues. Specifically, Sam shepherded facilities through payor audits and investigations, developed appeals strategies for denied claims and overpayment recoupments, and advised clients on compliant clinical practices given the ever-evolving standards to which behavioral healthcare providers are held.
Health Care Litigation Background
Prior to joining Nelson Hardiman, Sam represented physicians, mental health and addiction treatment providers, emergency room doctors and large hospital systems in reimbursement litigation. Sam has experience in State and Federal Court as well as in all major arbitration forums. Sam is well versed in ERISA preemption, usual customary and reasonable rate disputes, clinical standards, coding-related issues, mental health parity, participating provider agreement disputes, Knox-Keene Act Health Plans among others.
Deep Commitment to Access to Healthcare
Sam believes that an efficient healthcare ecosystem is critical to patients’ access to care. Sam also understands that the financial incentives at play in healthcare inevitably lead to disputes that require competent advocacy. Sam attended law school with the goal of using a legal education to meet the needs of healthcare stakeholders and ultimately improve the ability of Americans to get the healthcare they need without going bankrupt. In his role at Nelson Hardiman, Sam leverages his behavioral health and litigation experience to assist clients in both litigation and regulatory compliance matters.
University of California, Irvine, B.A. Cum Laude; Phi Beta Kappa
Georgetown University Law Center, J.D.
State Bar of California
United States District Court for the Central District of California
American Health Law Association (AHLA)
- Represented major hospital systems in successful arbitration and litigation against healthcare service plans, Medicare Advantage plans, and commercial payors to ensure fair claims payment.
- Represented hospital systems in Workers Compensation reimbursement disputes with Workers Compensation Insurers.
Class Action Litigation
- Briefed successful oppositions to motions to dismiss and motions for summary judgment in class action litigation against major payors for denied behavioral health claims.
- Represented emergency room physician network in RICO and Anti-trust reimbursement litigation against major payors and third-party cost containment companies.
- Represented class of healthcare providers in a range of ERISA matters, including preemption issues and benefits disputes.
Healthcare Industry Experience
- Advised healthcare providers on designing and implementing administrative procedures to ensure maximum collections and exhaustion of administrative remedies.
- Guided providers to successfully overturn thousands of claims denials.
- Resolved medical records audits and pre-payment review flags for behavioral health providers.
- Advised behavioral health providers on compliant marketing practices, records maintenance, HIPAA procedures, documentation, licensure, and coding.