Our Healthcare Industry team includes attorneys who dedicate their practices to representing healthcare providers in a wide range of administrative, civil False Claims Act, and criminal healthcare fraud enforcement matters. We are highly skilled in the numerous areas that are subject to enforcement, including referral relationships and anti-kickback statutes, HIPAA, coding and billing issues and medical necessity.
Administrative Enforcement
We routinely guide clients through audits and investigations conducted by the Centers for Medicare and Medicaid Services (CMS), Zone Program Integrity Contractors, Medicare Administrative Contractors, the U.S. Department of Health and Human Services (HHS), Office of Inspector General (OIG) and state inspector generals and regulatory agencies throughout the country. We assist our clients in conducting internal investigations and identifying potential error rates, responding to records requests and providing written and oral advocacy before enforcement authorities in an effort to avoid enforcement action. Should an enforcement action arise, we have substantial experience defending against a broad range of matters, including payment holds and suspensions, administrative penalty cases, overpayment demands, state department actions and OIG exclusion proceedings.
False Claims Act Enforcement
We partner with our provider clients across the country to manage and defend False Claims Act investigations from start to finish. We conduct internal investigations and audits, respond to administrative subpoenas and civil investigative demands and negotiate with the U.S. Department of Justice (DOJ), state attorneys general and other federal and state authorities for favorable resolutions of a False Claims Act investigation short of a trial. If the government or an individual relator pursues a case, our team has the right combination of healthcare law expertise and trial skills to defend clients in the courtroom.
Criminal Enforcement
As the government does not conduct healthcare fraud investigations in a vacuum, our clients have relied heavily on our team to provide counseling with respect to possible criminal allegations. Our team, which includes several former federal healthcare fraud prosecutors, has both the practical insight and substantive healthcare law experience to effectively respond to grand jury investigations and search warrants, obtain non-prosecution agreements and other favorable pretrial diversions, defend against indictments and, if necessary, try cases to bench trials or federal and state juries.