Fraud and Abuse Investigations and Claims
Our health law attorneys defend clients embroiled in government investigations and prosecutions involving allegations of federal and state healthcare law violations, including anti-kickback laws, the False Claims Act, billing fraud, and Stark Law violations. A major focus of our representation is to prevent exclusions from Medicaid (MassHealth) and Medicare.
We routinely counsel clients in investigations conducted by the U.S. Department of Justice (DOJ), U.S. Food and Drug Administration (FDA), Drug Enforcement Agency (DEA), Office of Inspector General of Health and Human Services (HHS OIG), Centers for Medicare and Medicaid Services (CMS), United States Attorney’s Offices, the Massachusetts Attorney General's Medicaid Fraud Division, and other federal and local government agencies. These investigations often first surface through a civil investigative demand, HIPAA subpoena, or grand jury subpoena.
We advise physicians and pharmacists on compliance with the Massachusetts Prescription Monitoring Program, including providing advice on prescribing, storage, and dispensing issues.
Before clients are targeted for investigation, our team conducts internal investigations to identify problems before they become liabilities. We can isolate concerns and help to correct them, and help clients avoid government enforcement actions. If necessary, we can also help clients with self-reporting and other types of voluntary disclosures to the government.