Industries & Practices

Compliance, Fraud & Abuse

Compliance, Fraud & Abuse

    We protect clients from fraud and abuse violations and stand by them should an investigation occur.

    Many of our attorneys focus specifically on fraud and abuse laws, including the Stark Law, the Anti-Kickback Statute, the Overpayment Statute, the Civil Monetary Penalties Law and the False Claims Act. We are skilled at structuring and implementing contracts, transactions and relationships, including hospital-physician relationships, to both comply with these laws and meet the business goals of the organization. Our team is known for identifying potential problem areas proactively and finding solutions that reduce risk.

    Additionally, we help clients resolve potential fraud and abuse compliance concerns. We investigate potential violations, develop corrective action/remediation plans and resolve problems effectively. 

    Our attorneys also have significant experience handling litigation related to fraud and abuse law. We have successfully worked with the Department of Justice (DOJ), the United States Attorneys’ Office, the Office of Inspector General (OIG) for the Department of Health and Human Services (HHS), and state attorney generals’ offices to resolve high stakes cases.

    Our experience includes:

    • Structuring complex health care transactions, including hospital-physician joint ventures, physician recruitment contracts, professional services contracts and other contractual arrangements
    • Developing alternative structures and solutions to achieve client goals while reducing the risk of violating fraud and abuse laws
    • Restructuring existing contracts and arrangements due to regulatory changes
    • Leading or assisting clients with conducting internal compliance investigations of potential violations of law/compliance concerns
    • Guiding voluntary self-disclosures of noncompliance and overpayments
    • Managing government-initiated matters (audits, investigations, and civil and administrative actions)
    • Defending clients in whistleblower (qui tam) actions
    • Handling Medicare/Medicaid and commercial payor reimbursement issues
    • Providing compliance training to board members, executives and employees