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How did a clerkship with Judge Merritt change the way Chris Climo approaches the practice of law? Find out more>

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Experience Spotlight

Primary Care Providers Win Challenge of CMS Interpretation of Enhanced Payment Law

With the help and support of the Tennessee Medical Association, 21 Tennessee physicians of underserved communities joined together and retained Bass, Berry & Sims to file suit against the Centers for Medicare & Medicaid Services to stop improper collection efforts. Our team, led by David King, was successful in halting efforts to recoup TennCare payments that were used legitimately to expand services in communities that needed them. Read more

Tennessee Medical Association & Bass, Berry & Sims

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Thought Leadership

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Thought Leadership Spotlight

Download the Healthcare Fraud & Abuse Review 2017, authored by Bass, Berry & Sims

The Healthcare Fraud & Abuse Review 2017 details all healthcare-related False Claims Act settlements from last year, organized by particular sectors of the healthcare industry. In addition to reviewing all healthcare fraud-related settlements, the Review includes updates on enforcement-related litigation involving the Stark Law and Anti-Kickback Statute, and looks at the continued implications from the government's focus on enforcement efforts involving individual actors in connection with civil and criminal healthcare fraud investigations.

Click here to download the Review.

Healthcare Fraud

Healthcare Fraud & Abuse

No industry faces more government scrutiny related to fraud and abuse than healthcare. From whistleblower lawsuits under the False Claims Act to industrywide investigations spearheaded by the U.S. Department of Justice to ever-changing Medicare compliance requirements, healthcare companies are exposed to a wide range of investigations and enforcement actions by both federal and state officials.

With our base in Nashville, the nation's healthcare capital, and our office in Washington, D.C., our healthcare fraud and abuse attorneys understand both the business and the politics of healthcare. Our counsel goes beyond the legal issues to consider all of the operational and management issues a healthcare organization faces when a healthcare fraud and abuse matter arises.

Government Enforcement

Download Healthcare Fraud and Review 2017, written by Bass, Berry & Sims attorneysWe routinely represent healthcare providers faced with fraud and abuse enforcement actions by the government and litigation stemming from those enforcement efforts. Our practice is led by our Healthcare Fraud Task Force, which includes former members of the U.S. Department of Justice and a number of former Assistant U.S. Attorneys with significant experience handling healthcare fraud matters across the country. Our attorneys bring the knowledge of having worked inside the government, providing great insight into how HHS-OIG, U.S. Department of Justice and the various State Attorneys' General offices think about fraud and abuse in healthcare and the strategies they use to pursue these cases.

We provide healthcare clients with counsel and support for every sort of civil and criminal exposure, across all sectors of healthcare, including:

  • Alleged violations of various healthcare fraud and abuse laws such as the Stark Law and the Anti-Kickback Statute
  • Litigation arising under the False Claims Act
  • Alleged violations of the Food, Drug and Cosmetic Act
  • Medicare compliance, Medicaid compliance and audits (RAC audits, ZPIC audits)

These civil and criminal actions threaten enormous potential damages and exclusion from Medicare and Medicaid – a loss of revenue that could imperil the viability of a healthcare provider. The attorneys on our Healthcare Fraud Task Force understand the high stakes involved through years of experience and detailed knowledge of healthcare regulations and fraud and abuse laws and the agencies that enforce them.

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Our healthcare attorneys encompass the multitude of legal specialties necessary to service one of the largest, most highly regulated industries in the United States. We bring our multidisciplinary, team approach to our representation of the following sectors and facilities:

  • Academic medical centers
  • Ambulatory surgery centers
  • Behavioral health
  • Cancer therapy
  • Clinical laboratories
  • Dermatology
  • Diagnostic imaging
  • Health plans, managed care companies and benefit management companies 
  • Healthcare information technology
  • Home health
  • Hospice
  • Hospitals and health systems
  • Life sciences
  • Managed care
  • Medical device
  • Nonprofit providers
  • Orthotics and prosthetics
  • Pharmaceuticals and pharmacies
  • Physician practices, outsourced physician services and management companies
  • Private equity
  • Revenue cycle management
  • Senior housing and long-term care
  • Specialty pharmacy and pharmaceuticals
  • Telemedicine
  • Urgent and retail care clinics
  • Wellness and disease management

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