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In Brief: A Digest of Healthcare Fraud and Abuse Projects

Client Success
  • Represented a three-hospital system that faced extensive federal civil liability for physician compensation agreements implemented before the firm’s representation. Our team conducted an internal investigation and counseled the client through a voluntary disclosure. We encouraged the federal government to consider legal theories that greatly reduced the government claims. Our client resolved the investigation with no criminal charges and no admissions that it violated the federal False Claims Act.
  • Analyzed compliance risks associated with federal food and drug regulations, False Claims Act and anti-kickback statutes for a merged medical device manufacturer. Wrote policies for conducting investigations and a manual for Foreign Corrupt Practices Act policies and procedures. Interviewed national sales team and made recommendations to prevent off-label marketing.
  • Settled a Stark Law violation with the Department of Justice (DOJ) and the Department of Health and Human Services & Office of Inspector General (HHS OIG) after a multiyear internal investigation, self-disclosure and extensive negotiations. The matter was resolved with no criminal charges, no admissions of False Claims Act violations, and no imposition of a corporate integrity agreement or government oversight.
  • Served as lead counsel for a healthcare system in conducting an internal investigation, making a self-disclosure and negotiating a settlement with the HHS OIG and DOJ, including defending the hospital from litigation brought by a physician included in the self-disclosure. The firm negotiated a first-of-its-kind settlement.
  • Performed comprehensive Stark and Anti-Kickback Statute compliance audits, resulting in corrective action plans and educational programs to improve compliance and avoid fraud and abuse issues.
  • Represented long-term care provider in response to state and federal civil investigative demands and subpoenas concerning purported anti-kickback violations.
  • Analyzed Anti-Kickback Statute, Stark and Civil Monetary Penalties Law risk in the development of deals, contracts and structures.
  • Represented physician group in responding to third-party discovery served in litigation concerning anti-kickback violations.
  • Represented hospice in settlement with the HHS OIG on Medicare qualifications for payment.
  • Represented cardiology group in unsealed False Claims Act litigation.