Position: Member

TEL: 310-312-4000

FAX: 310-312-4224

Email: Click Here

Website: www.manatt.com

Admitted: California, 1990

Law School: 

College: 

Birth Date and Place: 

Practice Areas: Commercial Civil Litigation, Healthcare Litigation, Insurance Defense

Additional Information: Mr. Pimstone is a litigation partner in the Los Angeles office and heads the firm’s national healthcare litigation practice. He is a member of the firm’s Board of Directors.

Mr. Pimstone represents companies in the healthcare field in a wide array of litigation and counseling matters in trial and appellate proceedings. He has been lead counsel in a wide spectrum of high-profile cases and has successfully persuaded courts and juries to establish new precedent in the field. In addition to representing companies in litigation, Mr. Pimstone routinely provides strategic counseling to address other legal, legislative and regulatory issues that impact companies in the healthcare arena.

In each of the past three years, the Los Angeles and San Francisco Daily Journals have named Mr. Pimstone one of the 100 most influential lawyers in California. The Chambers Guide lists Mr. Pimstone as one of the leading healthcare attorneys in California, and he is listed in “The Best Lawyers in America” and “Southern California Super Lawyers” publications. Mr. Pimstone co-authors the Rutter Group’s Practice Guide section on Managed Care as well as the BNA treatise on Managed Care Litigation. In the Fall of 2009, Mr. Pimstone taught Health Law at the University of California, Berkeley School of Law (Boalt Hall).

Mr. Pimstone is a graduate of the University of California at Berkeley, where he majored in Biology and Political Science. Mr. Pimstone remained at Berkeley for law school, graduating from Boalt Hall in 1990, where he was awarded several academic prizes and worked closely with Professor Sanford (“Sandy”) Kadish on his textbook “Criminal Law and Its Processes.” Mr. Pimstone’s recent cases have included the following:

In June 2009, Mr. Pimstone was trial counsel for Blue Shield of California in the high-profile case, Hailey v. California Physicians Service dba Blue Shield of California, which Mr. Pimstone tried to an Orange County jury. The case resulted in a verdict in favor of Blue Shield. The Hailey matter earlier had been the subject of a reported decision interpreting California’s “postclaims underwriting” laws. It was the first rescission case in California to proceed to jury trial.

Earlier in 2009, Mr. Pimstone obtained dismissals for his client in the United States District Court in Miami in two significant RICO actions that had been brought by nationwide classes of almost 1 million physicians, and other allied healthcare providers, alleging a conspiracy to underpay providers. After virtually all of the defendants in the case and its predecessor actions had settled for hundreds of millions of dollars in payments to the class, the federal court granted Mr. Pimstone’s client’s motions to dismiss the two cases with prejudice.

In 2008, the California Court of Appeal handed down a unanimous published decision in Mr. Pimstone’s Watanabe case that decided an issue of first impression in California: whether health plans can be held vicariously liable for delegated decisions made by contracted medical groups concerning benefit determinations rendered to plan members (insureds). Adopting the legal arguments advanced by Mr. Pimstone on behalf of his client and the industry, the Court of Appeal held that health plans are not vicariously liable for decisions delegated to medical groups. Had the decision gone the other way, California health plans would have faced immense tort liability for numerous decisions rendered on a daily basis by contracted medical groups, which could have altered the structure of managed care in California. Mr. Pimstone argued the appeal, and in the lower court he had successfully tried the Watanabe case to a Los Angeles jury.