Healthcare Fraud & Regulation
We assist individuals, entities, and other law firms with criminal and parallel issues related to healthcare fraud and abuse allegations in state and federal enforcement actions.
These issues include:
- Self-referral laws (Stark)
- Anti-kickback laws
- Fee-splitting laws
We have successfully defended clients in parallel investigations and proceedings conducted by the Office of Inspector General (state and federal), Department of Justice, United States Attorney’s Office, and the Arizona Attorney General.
Representative Cases
- Represented regional medical practice in U.S. Senate Finance Committee investigation. Investigation closed in the practice’s favor
- Successfully represented local practice in AHCCCS investigation regarding billing irregularities
- Successfully defended mobile dental practice against claims of violating AHCCCS billing rules and favorably resolved related Medicare issues with federal government
- Successfully resolved DEA record-keeping violation case against national pharmaceutical distributorship
- Successfully represented numerous individual physicians accused of Stark violations in connection with orthopedic device usage. Investigations closed and government claims not pursued
- Advised regional pharmaceutical distributorship concerning compliance with DEA record-keeping, distributing, and compounding regulations
- Advised online health care practice concerning state and federal regulations
- Successfully defended physician accused of AHCCCS and Medicare billing fraud
- Represented individual in FDA and state Attorney General investigation/prosecution concerning drugs imported from India. Achieved favorable civil resolution on behalf of individual
- Represented physician concerning investigation of weight-loss clinic. Investigation favorably closed
- Successfully represented physician in investigation of multiple pain management clinic practice
- Achieved favorable administrative resolution for dentist accused of AHCCCS billing fraud
- Successfully defended individual in HHS-OIG investigation of national dental practice concerning billing and patient treatment issues
- Represented chiropractor in state Attorney General billing fraud investigation which was closed in chiropractic physician’s favor
- Conducted an internal investigation of a physician practice group after the in-house counsel raised allegations of anti-kickback violations
- Conducted an investigation on behalf of a children’s dental clinic that was subject to a Corporate Integrity Agreement into allegations of physical abuse of patients by a dentist. The HHS-OIG ultimately took no action against the clinic
- Represented a dental clinic against allegations of billing fraud and performance of unnecessary procedures
- Representation of a physician into allegations of prescription of opioids for no legitimate medical purpose. The matter was resolved with an agreement that the physician enter into a deferred prosecution agreement and his DEA license was returned over a period of years
- Conducted an internal investigation at a hospital involving allegations of sexual harassment and other inappropriate behavior by a mid-level manager
- Representation of a physician accused of illegally selling scheduled drugs and defrauding AHCCCS by billing for services not rendered
- Successfully represented national, state, and local healthcare practices in Medicare. False claims act investigations and litigation
- Resolved Qui Tam case in favor of individual physician
- Resolved Qui Tam case in favor of regional medical practice
- On behalf of a hospital group, defended successfully a Qui Tam claim of broad allegations of fraud; conducted an internal investigation of upcoding at a hospital facility; and pursued a claim as the victim in a kickback scheme
- Represented a hospital system in a parallel criminal/False Claims Act investigation involving Stark issues arising out of its relationship with a world class practice group
- Internal investigation for a hospital involving inappropriate behavior by a doctor leading to peer review and loss of privileges; testified at the peer review hearing
- Defended the head of nursing in a death investigation at a nursing home