Experience

• HEALTHCARE

  • Achieved a favorable settlement for a managed healthcare and insurance company in a case involving risk adjustment practices under the Medicare Advantage program.
  • Helped to obtain a favorable settlement of an Anti-Kickback Statute (AKS) FCA case brought against a major pharmaceutical company arising from its speaker program.
  • Achieved a favorable settlement for a California county agency in a non-intervened FCA case alleging overbilling and improper billing for mental health services.
  • Representing a major pharmaceutical company in an AKS FCA investigation arising from the company’s speaker program.
  • Representing a major pharmaceutical company in a non-intervened AKS FCA case arising from the company’s speaker program and charitable donations.
  • Represented major pharmaceutical company in resolving civil and criminal allegations under the FCA relating to the company’s off-label promotion and alleged payment of kickbacks, through speaker programs and advisory boards.
  • Represented a major not-for-profit hospital system in an FCA investigation involving allegations of improper payments to surgeons and other potential AKS violations.
  • Persuaded the DOJ not to intervene and achieved a highly favorable settlement for a cancer screening test manufacturer in a qui tam action under the FCA involving allegations that sending patients gift cards to encourage patients to return lab samples for preventive cancer screening violated the AKS.
  • Providing counsel to a healthcare company that specializes in skilled nursing facility (SNF) services in connection with a federal FCA investigation into the provision of therapy and nursing services.
  • Providing counsel to a PACE provider in multiple federal and state FCA investigations involving quality of care and alleged AKS violations tied to Assisted Living Facilities.
  • Providing counsel to a large state hospital system in connection with federal FCA investigation into surgery scheduling practices and related alleged AKS violations.
  • Achieved a favorable settlement for a large state hospital system of a qui tam action and an investigation involving DOJ and the state attorney general’s office into allegations that hospitals were improperly billing Medicare, Medicaid, and Tricare for facility fees associated with emergency department visits.
  • Secured a dismissal for a prominent pharmaceutical company alleged to have made false marketing claims regarding its product. The district court dismissed the case, and the Fourth Circuit affirmed, holding that the general release of claims the relator signed upon leaving the company barred the relator's subsequent qui tam suit.
  • Represented a major pharmaceutical company in a novel suit brought under the qui tam provision of California’s Insurance Frauds Prevention Act by the California Insurance Commissioner and whistleblowers involving allegations of speaker programs, advisory bureaus, and indirect payments made to doctors to persuade them to prescribe certain drugs; obtained dismissal of whistleblowers on summary judgment.
  • Represented a major medical device company in a suit brought under California’s Insurance Frauds Prevention Act by a whistleblower; prevailed on summary judgment.
  • Negotiated a favorable settlement with the DOJ and multiple states for a consumer goods company, closing a sprawling civil and criminal investigation of FCA and other claims associated with the marketing of medication reimbursed by federal and state healthcare programs.
  • Two firm partners served as independent monitors for Tenet Healthcare Corporation following its $513M settlement with DOJ for violating the Anti-Kickback Statute.