Health Care Compliance, Fraud & Abuse, and Regulatory Counseling

• Draft compliance program documents and advise on compliance program implementation
• Design and provide compliance training presentations, including specialized sessions for sales force, billing, and other groups of employees
• Audit compliance programs to evaluate effectiveness and compliance with state and federal laws and guidance documents
• Advise on the fraud and abuse and other regulatory implications of a variety of business arrangements under state and federal law
• Counsel clients on compliance with state and federal certification and licensure requirements
• Represent clients facing adverse actions brought by state and federal certification and licensure agencies

• Federal fraud and abuse laws (Anti-Kickback Statute; the Stark Law; the False Claims Act; the Civil Monetary Penalties Law)
• State fraud and abuse laws (kickbacks; self-referrals; false claims; fee-splitting)
• Federal Physician Payments Sunshine Act
• State aggregate spend reporting laws
• Federal and state certification and licensure requirements (laboratories; retail clinics; hospitals; long-term and post-acute care providers; durable medical equipment suppliers; dialysis providers)

• Academic medical centers
• Accountable care organizations
• Hospitals and health systems
• Laboratories
• Medical technology manufacturers
• Post-acute and long-term care facilities
• Pharmacies and PBMs
• Physician / physician practices
• Retail clinics

Closely aligned with our leading Health Care Enforcement Defense Practice, which includes attorneys who have served in government agencies including the Civil Fraud Section of the DOJ; the Centers for Medicare and Medicaid Services; US Attorneys' Offices; Medicaid Fraud Control Units; and state attorneys general.