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Healthcare and FDA: Healthcare Fraud and Abuse (U.S.)

As one of the most heavily scrutinized industries in the United States, healthcare has been and will remain a primary target for allegations of fraud and abuse, which can expose those operating in the healthcare industry to government enforcement actions, qui tam lawsuits initiated by whistleblowers, significant civil and criminal liability, and potential exclusion from participation in federal programs.

When healthcare fraud and abuse matters arise, healthcare professionals need a legal team that possesses sophisticated defense skills on both the civil and criminal fronts, as well as a deep understanding of healthcare laws and regulations.

Our Healthcare Fraud and Abuse practice group is uniquely positioned to defend healthcare clients when the stakes are at their highest and when results are critical. It is composed of a powerful combination of lawyers from our White Collar Defense and Investigations and Healthcare practice groups, and supported as necessary by the firm’s e-Discovery Analysis and Technology (e-DAT) practice group. This collaboration offers a unique perspective that informs and drives the defense strategies and teams deployed for our clients.

Consisting of former US Attorneys and Assistant US Attorneys, as well as lawyers with significant experience handling the most sophisticated healthcare regulatory matters, the Healthcare Fraud and Abuse practice group is equipped to help clients navigate the inherent complexities and challenges of healthcare fraud and abuse investigations, including those associated with electronically stored information and electronic medical records. With team members located in our offices across the country and in virtually every region, the Healthcare Craud and Abuse practice group is able to meet our healthcare clients’ needs wherever, whenever, and however they arise. 

We routinely represent healthcare systems, hospitals, providers, and companies across the healthcare industry. These matters include investigations and litigation related to the False Claims Act, including actions initiated by the government and through qui tam or whistleblower lawsuits; the Stark Law and the Anti-Kickback Statute; the federal Food, Drug, and Cosmetic Act; and Medicare and Medicaid audits, including recovery audit contractor, zone program integrity contractor, and unified program integrity contractor audits. 

In addition to responding to federal investigations and litigation, our Healthcare Fraud and Abuse practice group routinely represents healthcare systems, academic medical centers, hospitals, healthcare corporations, and executives in proactively undertaking internal investigations triggered by external inquiries and internal compliance functions, and associated representation surrounding government proffers, disclosures, repayments, and revisions to internal policies and procedures. In conjunction with these internal investigations, the group also has significant experience handling Office of Inspector General Self-Disclosures and Centers for Medicare and Medicaid Services Voluntary Self-Referral Disclosure Protocol filings.  

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