Jun 02, 2022
We are committed to protecting the interests of clients in the healthcare industry, offering a deep understanding of the regulatory and business issues facing our clients. We combine our strong litigation experience with deep industry knowledge to counsel providers regarding ongoing operational issues and litigate complex matters in federal, state, and administrative proceedings.
Our attorneys provide comprehensive representation to hospitals, physicians practices, home healthcare agencies, nursing homes, and other industry providers in litigating issues critical to their operations. Whether our attorneys are defending providers in government audits or investigations or representing them in court hearings or administrative proceedings, we understand the strategic, operational, compliance, and regulatory issues our clients face.
Our approach to healthcare litigation matters includes:
- We understand and represent providers across the healthcare spectrum, including hospitals and healthcare systems, physicians, skilled nursing facilities, and other post-acute providers, as well as suppliers and other service providers. This depth of experience gives our litigators a solid understanding of the operational and regulatory environments facing our client, which is critical in developing successful strategies in disputes
- We represent clients in administrative and judicial proceedings and arbitrations, including federal and state reimbursement matters, certificate of need-related litigation, licensure and survey matters, and business disputes, including provider-payer issues
- We advise our clients regarding conduct implications under fraud and abuse laws, including the False Claims Act, the Stark laws, and the anti-inducement statutes
- We represent clients in government and private payer audits, appeals, and investigations, understanding the compliance implications of findings and how to appropriately mitigate or disclose issues to the government
- We defend providers in Qui tam litigation, including conducting internal investigations and advising clients with regard to compliance concerns
- We represent providers in administrative and civil litigation related to privacy and security issues, including HIPAA compliance
- We represent providers in PRRB appeals and related audit matters
- We regularly represent systems in staff credentialing, peer review matters, and related litigation
- We represent clients with regard to open meeting and open record disputes
Our interdisciplinary team includes former federal prosecutors and healthcare providers whose keen knowledge of the industry enables us to efficiently and effectively handle all the complex issues related to healthcare litigation.
With attention to detail and big-picture thinking, our attorneys have a deep understanding of the healthcare industry. We recognize that healthcare disputes are unlike other commercial disputes due to the unique payment and reimbursement models and regulatory framework. We also understand the importance of resolving healthcare disputes before litigation becomes a necessity, therefore we offer a range of risk-management strategies to our clients.
- Obtained Certificate of Need for hospice provider over two other competing applicants after 4-week trial, allowing provider to significantly expand its services and operations.
- Successful resolution of qui tam action against Hospital alleging violation of False Claims Act relating to emergency medical services.
- Successfully negotiated settlements on behalf of the government in matters involving the False Claims Act, Anti-Kickback Statute, and Stark Law.
- Serve as lead counsel for Hospital in connection with State Court litigation, American Arbitration Association Arbitration, mediation of Hospital/physician dispute, and sale of joint venture entity.
- Served as lead counsel for health system in connection with American Arbitration Association arbitration dispute with managed care payor alleging wrongful denials of payment for home health services.
- Represented providers (hospitals, physicians, home health agencies, hospice and skilled nursing facilities) in Medicare contractor audits and appeals, including experience in successfully reversing statistical extrapolations.
- Advised multiple providers regarding regulatory matters, including compliance issues, investigations and voluntary refunds.
- On behalf of the government, investigated and negotiated settlement of several matters under the Americans with Disabilities Act involving hospitals.
- Advised large healthcare provider in a False Claims Act investigation and response to civil investigative demand.
- Served as lead counsel in American Arbitration Association arbitration dispute with Medicare Advantage Management Care payor challenging reduced payment associated with Medicare sequestration reduction.
- Represented the subsidiary of a Fortune 500 diagnostic testing company in successfully enforcing restrictive covenants against a top sales representative. Despite having agreed to restrictive covenants, including a non-compete, the sales representative resigned and went to work for a competitor in the same territory. We filed suit on behalf of our client and obtained a preliminary injunction in federal court against the sales representative. Then, based on evidence obtained during discovery, the firm moved for summary judgment on behalf of our client. The Court granted summary judgment as to liability in favor of our client, finding that the sales representative had breached both his non-compete and his non-solicitation covenants. Shortly thereafter, the case settled favorably to our client.
- Successfully overturned Medicaid reimbursement, resulting in a moratorium on reviews of inpatient admissions by the state recovery auditor.
- Represented large healthcare system in arbitration of Medicare Advantage disputes as well as renegotiated participation contracts to include more favorable terms for the provider.