Health Care Fraud & Abuse

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As state and federal governments increase regulation, expand enforcement efforts, and intensify scrutiny of health care industry transactions and operations, health care entities need guidance from lawyers who know their industries, understand their legal requirements and can help them prevent, detect and resolve fraud and abuse issues.

Our health care fraud and abuse team litigates in courts of all levels and effectively resolve investigations conducted by the Department of Justice, United States Attorneys' Offices, the Office of Inspector General at the U.S. Department of Health and Human Services, and state Medicaid fraud enforcement authorities. We advise and defend clients regarding:

  •  The False Claims Act
  • The Criminal Health Care Fraud Statute
  • Unfair Trade Practice
  •  Search Warrants
  • Federal and State Anti-Kickback Statutes
  • Foreign Corrupt Practices Act and Qui Tam related matters
  • Secondary Payor Issues
  • Grand Jury Subpoenas and Proceedings
  • The Physician Self-Referral Law (Stark Law)
  • Medicare and Medicaid
  • Civil Enforcement Initiatives
  • Criminal Pleas, Trials, and Sentencing
  • The Civil Monetary Penalties Law
  • The Exclusion Authorities

Our Services

•    Assessing and structuring client business transactions to minimize the risk of violating state and federal fraud and abuse laws, including those with referral sources.

•    Handling government investigations and resolving potential fraud and abuse investigations and litigation.

•    Establishing, monitoring, and enforcing effective corporate compliance programs.  

•    Developing processes that will keep existing compliance policies current and effective.

•    Conducting thorough, discreet, and efficient self-audits, gap analysis, and internal investigations.

•    Implementing internal reporting and self-disclosure processes.

•    Negotiating corporate integrity agreements and providing compliance training.

•    Complying with EMTALA, licensure/certification, HIPAA, HITECH, and Sarbanes-Oxley requirements, among other laws.

•    Assisting in the negotiation, preparation, and maintenance of all contracts and leases with referral sources that are needed to assure compliance with health care fraud and abuse and related laws.
Additionally, we keep our clients current on the latest legal trends and the requirements and standards of the Office of Inspector General, Office of Civil Rights, and other similar authorities. When a violation occurs, we advise on disclosure obligations, self-reporting and remediation efforts and we defend our clients in government investigations and litigation.

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