Health Care Fraud

State and federal regulatory and law enforcement agencies such as the Federal Bureau of Investigation (FBI) and the Office of Inspector General (OIG) (a division within the Health and Human Services (HHS) Department) have become especially aggressive in investigating allegations of healthcare fraud. The healthcare statutes are written broadly to encompass many activities that most healthcare professionals would never believe could be deemed fraud or criminal. Nonetheless, violations of the healthcare fraud laws can lead to severe criminal and civil consequences. Over the years, we have represented healthcare executives and members of the management team, providers, hospitals, managed care and insurance professionals, doctors, pharmacists, nurse practitioners, and practice groups in a broad array of healthcare matters, including allegations of upcoding, kickbacks, antitrust violations, unnecessary and inappropriate procedures or care, improper coding, unbundling, and other fraud allegations. Many times, our clients also face qui tam (false claims) and whistleblower lawsuits seeking damages. These cases are brought by individuals motivated to make money. In fact, the Department of Justice (DOJ) recently encouraged whistleblower attorneys to make criminal referrals to the DOJ and U.S. Attorney’s Offices for suspected criminal violations. Our firm represents clients in all phases of a healthcare fraud case—civil and criminal investigations to qui tam litigation to trial.

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