Healthcare Fraud Defense
Federal and state investigations, False Claims Act defense, and criminal healthcare fraud cases.
COVID-Era Billing Under Retrospective Review
How the Section 1135 telehealth waivers that applied during the COVID-19 Public Health Emergency affect retrospective Medicare bil…
Defending a Declined Qui Tam Case
A declined qui tam case is not over. The relator can litigate alone under the False Claims Act, and the government retains real op…
Compliance Program Effectiveness as a Defense
How DOJ's charging factors and the Sentencing Guidelines' three-point culpability reduction reward a compliance program that actua…
Copay Assistance Programs and Federal Enforcement
OIG's independence rules for charity copay foundations, and the settlements, including Teva's $450 million resolution, that define…
Cooperation Credit in Federal Healthcare Settlements
DOJ's cooperation credit policy rewards early, complete disclosure in False Claims Act matters, but the same disclosure can expose…
Civil Investigative Demands: Negotiating Scope
A civil investigative demand can combine document production, interrogatories, and testimony under one order. Scope is negotiable…
Building an Effective Compliance Program That Counts
OIG's seven elements and DOJ's evaluation factors, and what compliance officers need to document to prove a compliance program act…
Anti-Kickback Safe Harbors Every Practice Should Know
Medical director pay, space leases, EHR donations, and value-based deals must fit a safe harbor exactly, or the Anti-Kickback Stat…
Civil Discovery in FCA Cases: Managing the Burden
Once a qui tam case is unsealed, discovery reaches years of claims data. Rule 26 proportionality and privilege protocol decide who…