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REPRESENTATIVE TRANSACTIONS – GOVERNMENT INVESTIGATION AND ENFORCEMENT ACTIONS

Representative Transactions – Government Investigations and Enforcement Actions (DOJ and State)

  • Represented a surgery center in an investigation by the Department of Justice, alleging medically unecessary anesthesia service and  violation of the Federal Anti-Kickback Statute.  The surgery center was dismissed from the case.
  • Represented a physician group practice in an investigation by the Department of Justice, alleging billing for urine drug screens that were not medically necessary in violation of the False Claims Act. Negotiated a $7.4 million settlement and corporate integrity agreement.  No liability was admitted. No Medicare exclusion for any owner.  No Disciplinary Action for any health care professional.
  • Represented a compounding pharmacy in an investigation by the Department of Justice, alleging the pharmacy knowingly billed for prescription drugs that were not medically necessary in violation of the False Claims Act. Negotiated a $4.7 million settlement.  No liability was admitted. No Medicare exclusion for any owner.  No Disciplinary Action for any health care professional.
  • Represented a compounding pharmacy in an investigation by the Department of Justice, alleging the pharmacy knowingly billed for prescription drugs that were not medically necessary in violation of the False Claims Act.  Negotiated a $1.6 million settlement.  No liability was admitted. None of the owners were excluded and none of the licensed health care professionals received any disciplinary action. No Medicare exclusion for any owner.  No Disciplinary Action for any health care professional.
  • Represented a compounding pharmacy in an investigation by the Department of Justice, alleging the pharmacy knowingly billed for prescription drugs that were not medically necessary in violation of the False Claims Act.  Negotiated a $3.7 million settlement. No liability was admitted. None of the owners were excluded and none of the licensed health care professionals received any disciplinary action. No Medicare exclusion for any owner.  No Disciplinary Action for any health care professional.
  • Represented a business associate in response to an investigation of a HIPAA complaint received by the Office for Civil Rights (“OCR”).  The OCR closed the case without any finding of a violation of the Privacy, Security or Breach Notification Rules.
  • Represented three (3) health care providers in an investigation by the Department of Justice, alleging the legitimacy of a patient/practitioner relationship for the prescriptions written by the practitioners for compounded medications.  We were able to convince the Department of Justice of the legitimacy of the patient/practitioner relationships and the cases were closed without any finding of any violation of law.

KEY CONTACTS

Elizabeth D. Shaw
Mary Kate Mahoney