Insights & Analysis
Practical guidance on PBM audits, federal investigations, compounding defense, DEA enforcement, telehealth compliance, and the regulatory pressures facing pharmacies and providers nationwide.
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License Renewal Disclosure Questions: Answering Accurately
State board renewals ask about arrests, convictions, and malpractice actions, and a false or incomplete answer is its own discipli…
License Reinstatement After Revocation
State boards and OIG program exclusions run separate reinstatement tracks, each with its own timing and its own standard for the r…
The Public Disclosure Bar and the Original Source Exception
What qualifies as a public disclosure under the False Claims Act, and how a relator can still proceed as an original source.
Running an Internal Investigation Without Waiving Privilege
Structuring an investigation under counsel and giving proper Upjohn warnings keeps privilege intact when a provider investigates i…
The Relator's Share: What Whistleblowers Actually Receive
The False Claims Act sets a statutory range for what whistleblowers actually recover, and what can reduce that share to nothing.
Restitution and Forfeiture in Healthcare Fraud Cases
Restitution compensates the victim's loss and forfeiture strips the offense's proceeds. Federal courts can order both, in full, ag…
The First-to-File Bar in Qui Tam Litigation
A federal statute blocks duplicate qui tam suits over the same fraud. How the first-to-file bar works, and how defendants use it.
Extrapolated Overpayments in Wound Care Audits
A single flawed sample can turn a handful of wound care claims into a six-figure Medicare demand. Sample composition is where thes…
Responding to an HHS-OIG Subpoena
How physicians and practices negotiate scope, manage document production, and complete privilege review after an HHS-OIG document…