Case Results
Selected outcomes from anonymized matters. Facts modified to preserve client confidentiality.
Featured ResultFederal · D.N.J.
All federal charges against a NJ physician dismissed
The Department of Justice dismissed its entire criminal case against a New Jersey urologist charged over alleged speaker-program kickbacks and Controlled Substances Act violations — the lone dismissal in an otherwise unbroken string of 35 related federal and state prosecutions. The client returned to practice.
Read the full case →We have defended clients against
DOJ
FBI
DEA
HHS-OIG
OptumRx
McKessonCase Highlights
Highlights from the record
Recoupment Reversed$4.7M
$4.7M demand reduced to $180K — a 96% reduction
OptumRx full-scope audit across three fill years on high-cost specialty medications.
Indictment DismissedDismissed
All charges dismissed — client returned to practice
DOJ dismissed its entire case against a NJ physician — the lone dismissal among 35 related prosecutions.
Network Reinstated7 Pharmacies
All 7 terminations reversed in one coordinated appeal
Seven New York pharmacies' OptumRx network terminations reversed in a single coordinated appeal.
Recoupment Reversed$2.1M
$2.1M clawback defeated in full — final demand zero
Express Scripts clawback overturned on extrapolation methodology challenge.
DOJ Declined$6M
Prosecution declined on $6M alleged fraud — no charges
DOJ declined criminal prosecution following defense-side proffer and witness preparation.
FCA DismissedDismissed
Lawsuit dismissed at the pleading stage — no trial, no payment
FCA case against oncology dispensing practice dismissed at pleading stage under Rule 9(b) particularity.
Network ReinstatedReinstated
Termination reversed — Caremark and Part D access preserved
Michigan pharmacy OptumRx termination reversed. Caremark and Medicare Part D access preserved.
Recoupment Reversed$1.4M
$1.4M demand cut by 88% after extrapolation challenge
UPIC Medicare recoupment demand reduced after extrapolation challenge and ALJ appeal.
Recent Highlights
Recent wins, by practice area
PBM Audit & Recoupment
9 matters
Network Termination Appeals
11 matters
Federal & Criminal Defense
6 matters
DEA, Medicare & Medicaid
6 matters
Geographic Record
Wins on the record in 38 states
Health Law Alliance defends pharmacies, providers, and corporate operators in all 50 states. The map shows where documented case outcomes have landed since founding — concentrated in the PBM-heaviest markets (NY, NJ, FL, CA, TX) but spanning the country.
38
States with Wins
$20M+
Recovered Nationwide
Recent Results
Three more from this quarter
DOJ declined a $6M alleged fraud prosecution
Defense-side proffer and witness preparation produced a declination on the eve of indictment. The matter closed without charges and without an OIG referral.
No charges filed
Express Scripts recoupment defeated
$2.1M clawback overturned on an extrapolation methodology challenge. Statistical sampling errors made the projection unsupportable. Final determination: zero.
$2.1M reversed in full
OIG closed without enforcement action
Self-disclosure accepted. No corporate integrity agreement required. No exclusion. The client returned to normal Medicare billing the following billing cycle.
Closed, no action
$20M+
Recovered for Clients
1,500+
Audits Overseen
5,000+
Matters Handled
2,500+
Clients Represented