John B. Shely, Health Care Attorney in Houston, Texas

John Shely concentrates his practice on managed care trials, including litigation involving providers, ERISA benefits and fiduciary duties, and bad faith insurance practices. He also brings extensive experience in handling a wide range of commercial disputes, both for managed care organizations and for businesses across various other sectors.

Mr. Shely is frequently retained to try cases that clients believe are likely to proceed to trial. In several matters, clients have engaged him late in the litigation process—sometimes transferring the case from another firm shortly before trial.

He has served as first chair in both jury and bench trials nationwide. For example, he was lead trial counsel for a national drugstore chain in a lawsuit where the plaintiffs sought hundreds of millions of dollars in damages related to alleged overpayments for prescriptions. The case went to trial before a 12-person jury in Delaware state court in May 2023. After two weeks of evidence and closing arguments delivered in the third week, the jury deliberated for less than three hours before returning a take-nothing verdict in favor of Mr. Shely’s client.

Since 2015 alone, Mr. Shely has tried 26 cases as first chair, achieving jury verdicts in four different states across both state and federal courts, in addition to numerous arbitrations. Clients have described him as an “everywhere” lawyer, recognizing his ability to try cases across diverse jurisdictions and connect effectively with juries. He is often brought in specifically when a jury trial is all but certain.

He has also argued before the United States Courts of Appeals for the Fifth and Tenth Circuits, the Supreme Court of Texas, various Texas appellate courts, and other appellate courts on numerous occasions. Over the course of nearly 40 years, Mr. Shely has served as lead counsel for managed care companies in high-profile cases that have helped shape the legal framework governing the industry. Key examples include his representation of managed care organizations in a successful challenge to the Texas HMO Health Care Liability Act, and his role as lead counsel in the lower courts for two of the three cases that were consolidated in Aetna Health Inc. v. Davila, 542 U.S. 200 (2004)—a landmark U.S. Supreme Court decision concerning ERISA removal preemption.

Much of Mr. Shely’s current practice involves disputes between managed care companies and healthcare providers. These include arbitrations and lawsuits with in-network providers, putative class actions brought by physicians, efforts to counter chargemaster abuse by out-of-network providers, and defense against claims involving substantial prompt pay penalties.

A major component of his practice addresses provider schemes involving improper or fraudulent billing. Among the more notable matters is a case in which his client secured a $41 million judgment against an out-of-network hospital for billing fraud related to fee forgiveness and kickbacks to physician-owners. He also frequently handles cases involving alleged fraudulent laboratory billing schemes.

Mr. Shely has represented clients in numerous pension and fiduciary duty claims under ERISA and has defended multiple class certification efforts. For example, he has secured favorable outcomes for managed care companies in class actions alleging: (i) breach of fiduciary duty under ERISA due to nondisclosure of financial incentive arrangements, and (ii) alleged violations of the Lanham Act. He has deep experience concerning the scope and application of ERISA preemption to varied factual scenarios.

Additionally, Mr. Shely has tried numerous ERISA benefits cases in federal court, including matters involving injunctive relief tied to COBRA issues and provider deselection from managed care networks. Many of his cases have also been resolved in favor of clients through successful pretrial motion practice, thereby avoiding trial altogether.