Experience

We have successfully represented health care providers in civil, criminal, and administrative matters. For example, we represent or have represented the following clients:

  • A hospital in a federal investigation initiated by a former physician employee into alleged DRG upcoding. Based on our presentation to the government, it declined to prosecute and the whistleblower action and was settled for nuisance value.
  • A mental health/substance abuse provider in a settlement of federal and state false claims act investigations.
  • A multi-state behavioral health practice in a joint federal/state false claims act investigation, resulting in declination by the U.S. Attorney's Office and the state Attorney General's Office.
  • Hospital clients responding to third-party subpoenas in criminal and civil investigations in Connecticut, New York, and Pennsylvania.
  • A hospital physician executive in successfully defending against a U.S. Department of Health and Human Services (HHS) Office of Inspector General- (OIG) imposed exclusion.
  • An outpatient psychiatric clinic for children, through a state criminal and civil False Claims Act investigation.
  • A nursing home company against federal False Claims Act allegations involving RUG upcoding.
  • A multi-site physical therapy practice in criminal and civil investigations into billing practices, resulting in (1) the government's decision not to pursue criminal charges, and (2) a favorable civil settlement.
  • Numerous hospitals in Stark Law Self-Disclosures, including successful settlement of multiple Stark issues for a hospital client.
  • Various hospitals, home health care agencies, mental health and substance abuse providers, dentists, physicians, clinical laboratories, dialysis centers, pharmacies, and service providers for the developmentally disabled, in Medicaid audits where we consistently achieve successful results. In many cases, we have settled audits during the appeal stage for significantly less than the audit disallowance, and in one proceeding that went before a hearing officer, we obtained a ruling that struck down the state's $1 million audit finding.