Health Care Litigation & Qui Tam Investigations

Details

HunterMaclean’s skilled health care lawyers provide comprehensive legal services to health care providers, physicians and specialty practice groups, pharmaceutical companies, and other organizations within the healthcare industry facing complex litigation and investigations. With a deep understanding of the health care industry and experience in navigating the intricate landscape of health care law, HunterMaclean’s health care team provides strategic counsel and aggressive representation to our clients.

Health Care Litigation

Our health care litigation services cover a wide range of disputes and regulatory issues, including but not limited to:

• Regulatory Compliance and Enforcement Defense: We represent health care providers and organizations against regulatory enforcement actions brought by state and federal agencies, including matters involving the Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), and the Office of Inspector General (OIG).
• Fraud and Abuse Defense: We represent clients facing allegations of health care fraud, including violations of the False Claims Act (FCA), Anti-Kickback Statute (AKS), and Stark Law.
• Commercial Litigation: Our firm handles a wide range of commercial disputes within the health care sector, including breach of contract, partnership disputes, and intellectual property litigation.

Qui Tam Investigations and Defense

False Claims Act liability exposes health care organizations to substantial damages and penalties in cases initiated by the U.S. Department of Justice, state attorneys general, and whistleblowers. Our services include:

• Whistleblower Defense: Defending health care providers and organizations against qui tam lawsuits.
• Internal Investigations: Conducting thorough internal investigations to identify and address potential compliance issues before they escalate.
• Government Investigations: Representing clients in investigations initiated by federal and state agencies, including the Department of Justice (DOJ) and the Office of Inspector General (OIG).
• Negotiating Settlements: Skillfully negotiating settlements with the government to minimize exposure and financial impact.

Experience

• Defense jury verdict obtained after a 5-week trial of a national pharmaceutical distributor in an opioid lawsuit of first impression brought by twenty-one plaintiffs seeking over $200 million in damages. (Link)
• Represented a major health care system in criminal and civil fraud and abuse and tax fraud investigation by the USDOJ alleging violations of the federal Stark law and the federal Anti-Kickback Statute (U.S. District Court, Southern District of Georgia).
• Represented a health care executive in USDOJ investigation of federal False Claims Act violations (U.S. ex rel. Rogers v. Azmat, U.S. District Court, Southern District of Georgia) (Link).
• Represented a major health care system in USDOJ’s initial investigation of alleged federal Stark law, federal Anti-Kickback Statute, and federal False Claims Act violations relating to physician compensation, fair market value and commercial reasonableness issues (U.S. District Court, Southern District of Georgia).
• Represented a large health care system in USDOJ’s investigation of alleged federal Stark law, federal Anti-Kickback Statute, and federal False Claims Act violations relating to a cancer center joint venture (U.S. District Court, Northern District of Mississippi).
• Representing a major hospital system in U.S. Department of Justice qui tam/whistleblower investigation and settlement involving the False Claims Act, Stark, and the Anti-Kickback Statute
• Obtaining a dismissal of a defendant in a U.S. Department of Justice qui tam/whistleblower action against a health system and members of its medical staff
• Successful defending a Medicare audit and reducing an alleged overpayment from more than $2M to just over $8,000
• Represented a large physician practice in a False Claims Act qui tam action involving numerous allegations of healthcare fraud and abuse. The case included a successful appeal to the Eleventh Circuit Court of Appeals regarding whistleblower share and attorney fees.
• Represented a chain of nursing homes and its owner in a False Claims Act investigation involving improper Medicare billing of services. The engagement included the negotiation of a corporate integrity agreement with the OIG.
• Represented a national teleradiology company and its owner in a False Claims Act qui tam action regarding allegations of improper billing.
• Represented a cardiology practice and a podiatry practice in a False Claims Act qui tam action involving allegations of upcoding, Stark Law and Anti-Kickback violations, and substandard quality of care. A central issue involved the ownership structure of a surgery center.
• Represented a physician practice in a False Claims Act qui tam action involving allegations of Anti-Kickback violations through “sham” agreements with outside vendors and suppliers.
• Represented a hospital in a False Claims Act qui tam action involving outpatient hyperbaric oxygen therapy and other wound care services. DOJ declined to intervene and the matter was dismissed.
• Represented an orthopedic practice in a False Claims Act investigation involving allegations of improper injections and treatments.
• Represented a pain practice in a multi-district OIG investigation involving allegations of improper treatment, billing, and lab orders.
• Represented a podiatry practice in a large healthcare fraud investigation. No criminal charges were filed, and the case was resolved through a civil settlement.
• Represented a pulmonology practice in a False Claims Act investigation involving billing for critical care services, documentation, and allegations of upcoding.
• Represented business owners and healthcare providers prosecuted by the DOJ Healthcare Fraud Strike Force in conjunction with Operations Brace Yourself, Double Helix, and Rubber Stamp.

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