Health Care Enforcement & Investigations

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To succeed in today’s delicate health care environment, clients need more than top-level legal advice. They need a partner who has strong relationships with the regulators interpreting the law and the authorities and agencies enforcing it. Our attorneys have built a reputation as front-runners in the industry and have the qualifications necessary to provide resourceful resolutions to even the most challenging dilemmas.

At 
Dickinson Wright, our comprehensive knowledge of all facets of health care law combined with our strong connections with government agencies allows us to efficiently mandate government investigations and skillfully negotiate innovative settlements for our clients.

Our Clients

We have successfully represented and defended numerous individual health care professionals and practices investigated by federal, state, local, and administrative agencies for various types of wrongdoing, including Medicare, Medicaid, and Tricare fraud; violations of the Anti-Kickback and Stark laws; as well as wire fraud, conspiracy, and other types of criminal and regulatory wrongdoing. We have also negotiated many global settlements, a frequently beneficial process for assisting health care entities in determining all imminent issues with multiple state and federal bodies.

Our Team

Dickinson Wright’s health care investigations and enforcement team has worked with nearly every U.S. health care regulatory and enforcement agency to decide and resolve numerous inquiries, investigations, and settlements. Those agencies include the following:

 

  • Department of Justice (DOJ)

  • Federal Bureau of Investigation (FBI)

  • Department of Health and Human Services (HHS)

  • Office of Inspector General (OIG)

  • Centers for Medicare & Medicaid Services (CMS)

  • Food and Drug Administration (FDA)

  • Department of Veterans Affairs (VA)

 Additionally, many of our attorneys have worked at the United States Attorneys’ offices, the Securities and Exchange Commission, and state and local prosecutor offices throughout the country.

Our Services


• Compliance with the Anti-Kickback Statute, the Stark Law, the Beneficiary Inducement Law, the False Claims Act, and Medicare and Medicaid reimbursement, including coverage, coding (i.e., CPT and HCPCS), and payment.

• Regulatory matters, including certification, inspections, surveys, certificates of need, provider-based status, licensure, and ownership changes.

• Investigations for a variety of health care entities and individuals, including academic medical centers, ambulatory surgical centers, device manufacturers, hospices, hospitals, and pharmaceutical companies.

• All aspects of government investigations, from requests for documents or subpoenas to witness interviews, negotiation with agency personnel, the structuring of plea negotiations and settlements, or trial.

• Negotiating corporate integrity agreements or certification of compliance agreements and assisting with related compliance and reporting activities. 

Representative Matters

 

–Secured no charges for the CEO of a New York Stock Exchange-listed health care industry company in a federal criminal investigation and a parallel SEC investigation.


–Obtained probation sentence for the owner of a health care medical equipment company indicted in a federal criminal case in Eastern District of New York for conspiring to overbill Medicare for durable medical equipment.


–Investigated a $6 million Medicaid and education fraud scheme, alleging improper Medicaid billing for special education services and the diversion of federal and state education funds for personal expenditures.

 

Represented the owner of a durable medical equipment company alleged to have improperly inflated Medicare/Medicaid claims.

 

Investigated a non-profit charter school for submitting millions of dollars in false claims to Medicaid for special education services.


–Investigated representations by medical device manufacturers regarding the efficacy of devices.

 

Represented specialty pharmacy owners in an embezzlement matter.

 

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