Samantha’s practice focuses on a wide array of federal, state, and administrative health care enforcement defense matters. She defends health care companies and providers in investigations conducted by the US Department of Justice and/or its US Attorneys’ Offices, which are often initiated by qui tam complaints filed under the federal False Claims Act. Samantha also represents clients in investigations and audits conducted by federal and state enforcement and administrative agencies, including state Offices of the Attorney General. She also structures and executes internal investigations stemming from government inquiries, as well as potential compliance issues identified by clients.
In addition, Samantha advises clients regarding compliance with the federal Anti-Kickback Statute, the Eliminating Kickbacks in Recovery Act, the Stark Law, and the False Claims Act, among other state and federal statutes and regulations. Samantha also has experience preparing self-disclosures and other reports relating to such enforcement matters, as well as developing internal compliance programs.
In addition to enforcement defense matters, Samantha handles licensure, reimbursement, and regulatory matters for a variety of health care clients.
Samantha is actively involved in pro bono matters at Mintz and previously served on the firm’s Pro Bono Committee. She manages the firm’s participation in the Lawyers Clearinghouse Legal Clinic for the Homeless, through which Mintz attorneys provide legal representation to residents of Boston-area homeless shelters. She also represents a wide variety of clients seeking pro bono services.
Before joining Mintz, Samantha completed a fellowship as a Special Assistant District Attorney for the Suffolk County District Attorney’s Office.
Experience
- Represented a diagnostics company in a national criminal and civil investigation involving multiple US Attorneys’ Offices and state Attorneys' General Offices. The investigation involved alleged kickback issues and billing violations with respect to the Medicare, Medicaid, and TRICARE programs, among other federal health care programs.
- Represented specialty laboratories in False Claims Act investigations in connection with the payment of processing and handling fees for specimen collection.
- Represented a large physician practice in several investigations, including alleged violations of the Anti-Kickback Statute and False Claims Act violations stemming from medically unnecessary procedures.
- Conducted internal investigations of several health care providers and prepared self-disclosures to the U.S. Department of Health and Human Services, Office of Inspector General (OIG) and Centers for Medicare & Medicaid Services (CMS).
- Represented several clinical laboratories in administrative proceedings, opposing loss of CLIA certification and the imposition of the two-year owner/operator ban.
- Successfully opposed the OIG’s proposed exclusion of a physician from participation in federal health care programs.
viewpoints
Supreme Court Declines to Weigh in on Requiring Objective Falsity in FCA Medical Necessity Cases
February 24, 2021 | Blog | By Samantha Kingsbury
As our readers know, we have long been closely watching False Claims Act (FCA) cases across the country alleging the submission of false claims based on the lack of medical necessity, particularly as a possible circuit split seemed to be developing with respect to requiring “objective falsity” to allege such FCA violations. And we have likewise been waiting to see if the issue will be decided by the Supreme Court. On February 22, 2021, we got an answer – at least for now – when the Supreme Court denied a petition for certiorari in RollinsNelson LTC Corp. et al v. U.S. ex rel. Winters, a FCA case out of the Ninth Circuit in which the defendant was accused of submitting claims to Medicare for medically unnecessary hospital admissions (which we have been following since last year).
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Health Care Enforcement Year in Review & 2021 Outlook
February 18, 2021 | | By Eoin Beirne, Brian Dunphy, Karen Lovitch , Kevin McGinty, Samantha Kingsbury, Keshav Ahuja, Grady Campion, Jane Haviland, Caitie Hill
Despite the threat of COVID-19 paralyzing much of the country in 2020, government health care fraud enforcement continued even though the Department of Justice (DOJ) had the added burden of pursuing COVID-19 related fraud. Mintz’s Health Care Enforcement Defense team has reviewed the key policy issues, statistics, settlements, and court decisions from 2020, and in this report we reflect on those developments and also predict the trends in health care enforcement in 2021 and beyond.
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DOJ Announces Another Increase to Already-High False Claims Act Penalties
June 26, 2020 | Blog | By Samantha Kingsbury
Last Friday, the Department of Justice (DOJ) announced another increase to civil monetary penalties assessed under the False Claims Act (FCA), among other statutes. DOJ made these adjustments to account for inflation, in accordance with the Bipartisan Budget Act of 2015, and they apply to penalties assessed after June 19, 2020, for violations occurring after November 2, 2015.
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OIG Updates Its COVID-19-Related FAQ Guidance to Okay Certain Specimen Processing Payments by Laboratories
May 12, 2020 | Blog | By Samantha Kingsbury
A few weeks ago, we posted about a publication by the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) of responses to certain frequently asked questions (FAQs) received from the health care community regarding regulatory flexibility for providers that needed it to adequately respond to COVID-19 concerns. This flexibility specifically relates to the OIG’s administrative enforcement authorities, including the federal Anti-Kickback Statute (AKS) and Civil Monetary Penalties Law prohibiting beneficiary inducement (Beneficiary Inducement CMPL).
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OIG Publishes FAQs Addressing Application of Its Administrative Enforcement Authorities During the COVID-19 Public Health Emergency
April 28, 2020 | Blog | By Samantha Kingsbury, Karen Lovitch
On Friday, the Office of Inspector General for the U.S. Department of Health and Human Services (OIG) issued responses to a series of frequently asked questions (FAQs), in an effort to provide some level of regulatory flexibility for health care providers responding to COVID-19 concerns. These FAQs relate to enforcement of the OIG’s administrative enforcement authorities under the federal Anti-Kickback Statute (AKS) and Civil Monetary Penalties Law prohibiting beneficiary inducement (Beneficiary Inducement CMPL) only.
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Practical Tips and Guidance for Understanding and Using HHS's Stark Law Blanket Waivers and the OIG’s Policy Statement About Them
April 21, 2020 | Blog | By Samantha Kingsbury, Hope Foster
As many of our readers know, as a result of the public health emergency caused by COVID-19, effective March 1, 2020, the U.S. Department of Health and Human Services (“HHS”) issued blanket waivers of its authority under Section 1877(g) of the Social Security Act (which authorizes the imposition of certain sanctions for violations of the Stark Law) with respect to 18 categories of remuneration and/or referrals (the “Blanket Waivers”).
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DOJ Is Already Making Good on AG Barr’s Instruction to Detect, Deter, and Punish Wrongdoing Related to Coronavirus
April 7, 2020 | Blog | By Samantha Kingsbury
On March 16th, Attorney General William Barr issued a memorandum to all United States Attorneys directing each U.S. Attorney’s Office (USAO) to “prioritize the detection, investigation, and prosecution of all criminal conduct related to the current pandemic,” noting that “the pandemic is dangerous enough without wrongdoers seeking to profit from public panic.” It appears that USAOs have wasted no time in prioritizing such cases, as the owner of a Georgia-based marketing company that generated leads for medical-testing companies was arrested earlier this week and charged with conspiracy to commit health care fraud and conspiracy to violate the Anti-Kickback Statute.
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Ninth Circuit Joins Several Others in Finding that Lack of Medical Necessity Claims Can Proceed Under the False Claims Act
April 2, 2020 | Blog | By Samantha Kingsbury
The Ninth Circuit Court of Appeals recently allowed a False Claims Act (FCA) case based on an alleged lack of medical necessity to proceed, rejecting the lower court's decision that subjective medical opinions about the necessity of hospitalization cannot be "objectively false." The Ninth Circuit joins several other circuits (including the Third Circuit, which recently issued the Druding decision that we posted about a few weeks ago) in reaching this decision, which has been a rapidly evolving area of FCA law.
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Effects of Social Distancing and COVID-19 on Government Investigations & Proceedings Still Developing
March 20, 2020 | Blog | By Samantha Kingsbury
In the midst of the upheaval caused by social distancing and related efforts to minimize and contain COVID-19-related risks, we have been monitoring steps taken by the Department of Justice (DOJ), the U.S. Attorneys’ Offices (USAOs), and federal courts to adapt to these circumstances. Any steps taken are sure to affect ongoing government investigations and related proceedings and how we, as defense counsel, approach them.
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Landmark AseraCare Case Finally Ends in Settlement
March 2, 2020 | Blog | By Samantha Kingsbury, Brian Dunphy, Laurence Freedman
As many of our readers know, the AseraCare case was closely watched over the last several years because of its significance to efforts by the Department of Justice (DOJ) to allege that submission of claims for services lacking “medical necessity” violate the False Claims Act (FCA) as well as to efforts by providers to defend such cases. On Wednesday, we learned that the AseraCare case has reached its dramatic conclusion with an agreement to resolve $200 million in alleged damages for the agreed amount, as reported by AseraCare, of $1 million.
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News & Press
Special Report: The 2024 Lab Enforcement Landscape
August 29, 2024
Health Law Practice Chair Karen Lovitch and Of Counsel Samantha Kingsbury were quoted in a G2 Intelligence special report about the 2024 lab enforcement landscape.
Healthcare Enforcement & Litigation 2022
August 27, 2021
Mintz Member and Chair of the firm’s Health Law and Health Care Enforcement Defense Practices Karen Lovitch, Member Laurence Freedman, Of Counsel Samantha Kingsbury, and Associates Grady Campion and Caitlin Hill co-authored the Global Overview and corresponding United States chapter of the seventh edition of Lexology’s Healthcare Enforcement & Litigation 2022. Together these pieces outlined federal enforcement priorities in 2020, including matters involving opioids, COVID-19-related fraud, Medicare, and more, and look ahead to how health care enforcement is expected to evolve in the coming year.
Health Care Fraud Investigations and Litigation Offer Unexpected Lessons from Bankruptcy Counsel
May 1, 2019
Given the many substantive and strategic lessons to be learned from FCA investigations and litigations, bankruptcy counsel advising the various constituents impacted by an FCA case should be mindful of these potential lessons, as they may raise issues relevant to the bankruptcy estate, says Health Law attorney Samantha Kingsbury in this article.
2017 Health Care Enforcement Review: Final Thoughts
January 19, 2018
Karen Lovitch, practice leader of the Mintz Health Law Practice, Eoin Beirne, a Member in the firm’s Litigation practice, along with Associates Samantha Kingsbury and Mackenzie Queenin authored the last in a four-part series of articles on health care enforcement trends in 2017.
Health Care Enforcement Review And 2017 Outlook: Part 2
January 17, 2017
Three attorneys from Mintz author the second installment of a four-part series recapping key government policies, regulations and enforcement actions from 2016 and discussing their potential impacts on 2017.
What Is The Anti-Kickback Statute?
January 1, 2015
Mintz Member and Chair of the Health Law Practice Karen S. Lovitch, Member Thomas S. Crane, and Associate Samantha P. Kingsbury co-authored a book published by the American Bar Association examining the federal Anti-Kickback Statute, one of the best-known federal fraud and abuse statutes, which prohibits transactions intended to induce or reward referrals for items or services reimbursed by the federal health care programs. The criminal statute has wide-ranging effects on business relationships in the health care, pharmaceutical, and medical device sectors.
Events & Speaking
Publications
Co-author, What Is...The Anti-Kickback Statute?, Second Edition, Published by the American Bar Association (2022)
Read lessRecognition & Awards
Included on the Massachusetts Super Lawyers Rising Star: Health Care list (2017-2019)
Phi Beta Kappa
Involvement
- Member, American Health Lawyers Association
Recent Insights
Health Law Practice Chair Karen Lovitch and Of Counsel Samantha Kingsbury were quoted in a G2 Intelligence special report about the 2024 lab enforcement landscape.
