We served as lead counsel representing one the largest privately-held skilled nursing facility companies in the country in connection with a company-wide investigation by the Department of Justice (DOJ) concerning the medical necessity of therapy services. We negotiated a successful resolution of the False Claims Act allegations, which resulted in a settlement involving less than 10% of company-affiliated skilled nursing facilities.
Representation of Skilled Nursing Facility Company: U.S. ex rel. Wright v. Saber Healthcare Holdings (E.D. Va.)
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We represented a global for-profit health insurance company with more than 20 million members in False Claims Act (FCA) litigation in federal court in the Northern District of Illinois.
Representation of ED company and other defendants in qui tam lawsuit alleging that ED provider’s violation of licensure laws caused submission of false claims and that defendants fraudulently billed services as performed by physicians even though patients were seen only by nurse practitioners. We obtained dismissal of the licensure claims and received summary judgment as to the upcoding claims. U.S. ex rel. Taylor v. Boyko, 2020 WL 520933 (S.D. W. Va. Jan. 31, 2020); U.S. ex rel. Taylor v. Perni, 2020 WL 2499544 (S.D. W. Va. May 14, 2020).