• U.S. ex rel. Sullivan v. Murphy Medical Center (W.D.N.C.) We are defending Murphy Medical Center and Erlanger, the nation’s seventh largest teaching hospital, in an intervened FCA litigation in which DOJ alleges violations of the Stark Law in connection with physician compensation. This matter is ongoing.
  • U.S. ex rel. Carroll v. Hackensack Meridian Pascack Valley Med. Ctr. (D.N.J.) We serve as lead counsel representing a multistate hospital ownership company and two of its hospitals in a lawsuit alleging FCA violations concerning the medical necessity of inpatient admissions for surgical procedures. The district court granted our motion to dismiss for familiar to plead in accordance with Rule 9(b) and failure to plead materiality.
    Reported Case: U.S. ex rel. Carroll v. Hackensack Meridian Pascack Valley Med. Ctr., 2023 WL 8664583 (D.N.J. Dec. 14, 2023)
  • U.S. ex rel. Liebman v. Methodist Le Bonheur Healthcare (M.D. Tenn.) We are defending a six-hospital system and one of the largest health systems in Western Tennessee, in FCA litigation filed by the United States alleging that their financial arrangements with an oncology practice violated the AKS. The financial arrangements between Methodist and the oncology practice exceeded hundreds of millions of dollars over the lifetime of the arrangements, making this lawsuit one of the largest AKS cases brought by the United States. After significant litigation and over several years, our team negotiated a favorable settlement on behalf of our client.
  • U.S. ex rel. Adams v. Chattanooga Hamilton County Hospital Authority (E.D. Tenn.) We are defending Erlanger Health System, the nation’s seventh largest teaching hospital, in FCA allegations of improper billing to Medicare and Tennessee’s Medicaid program for overlapping surgeries and leaving trainees to complete operations without physician supervision. This matter is ongoing.
  • U.S. ex rel. Wilkerson v. RCHP-Florence, LLC (N.D. Ala.) We represented a Muscle Shoals, Alabama-based hospital in connection with an FCA lawsuit alleging medically unnecessary services and violations of the Anti-Kickback Statute (AKS) in connection with the hospital’s inpatient psychiatric unit. The district court granted the hospital’s motion to dismiss the relator’s substantive FCA claims.
    Reported Case: U.S. ex rel. RCHP-Florence, LLC, 2023 WL 2730259 (N.D. Ala. Mar. 30, 2023)
  • U.S. ex rel. George v. Gupta (E.D. Tenn.) We served as lead counsel representing Community Health Systems and its affiliated hospital in connection with a DOJ investigation of alleged FCA violations concerning a physician relationship, which resulted in declination by DOJ and dismissal of relator’s claims for failure to prosecute.
  • U.S. ex rel. Benaissa v. Trinity Health (D.N.D.) We served as lead counsel representing Trinity Health, a not-for-profit North Dakota health system, in an FCA lawsuit alleging that attending physicians provided insufficient levels of supervision to residents. Resulted in dismissal following a motion to dismiss. The district court’s decision was affirmed by the Eighth Circuit.
    Reported Cases: U.S. ex rel. Benaissa v. Trinity Health, 2018 WL 6843624 (D.N.D. Dec. 31, 2018); U.S. ex rel. Benaissa v. Trinity Health, 2020 WL 3455795 (8th Cir. June 25, 2020)
  • U.S. ex rel. Maur v. Hage-Korban (W.D. Tenn.) We served as lead counsel representing two hospitals in a qui tam FCA lawsuit alleging that a cardiologist billed Medicare and Medicaid for medically unnecessary stent procedures. The district court ruled that the relator’s claims were barred by the public disclosure bar and for failure to plead fraud claims with particularity. The district court’s decision was affirmed by the Sixth Circuit.
    Reported Cases: U.S. ex rel. Maur v. Hage-Korban, 2020 WL 912753 (W.D. Tenn. Feb. 25, 2020); U.S. ex rel. Maur v. Korban, 981 F.3d 516 (6th Cir. 2020)
  • U.S. ex rel. Clemmons v. Vaughan Regional Medical Center (S.D. Ala.) We served as lead counsel representing a Selma, Alabama-based hospital in connection with a DOJ investigation and negotiation of a successful resolution of FCA allegations involving emergency department services and supervision of residents.
  • U.S. ex rel. Griffin v. Livingston Regional Hospital (M.D. Tenn.) We served as lead counsel representing a Livingston, Tennessee-based hospital in a DOJ investigation and negotiation of a successful settlement of FCA allegations involving medical necessity of in-patient psychiatric services.
  • U.S. ex rel. Whipple v. Chattanooga-Hamilton Cnty. Hosp. Auth. (M.D. Tenn.) We represented a multi-state non-profit hospital system in FCA litigation in a DOJ investigation of alleged FCA violations concerning the billing of inpatient stays, renal dialysis services, and carotid artery stenting procedures. Resulted in declination by DOJ. We obtained a successful resolution of the matter, after significantly narrowing the scope of the case through negotiations with relator’s counsel and a motion for judgment on the pleadings.
    Reported Cases:  U.S. ex rel. Whipple v. Chattanooga-Hamilton Cnty. Hosp. Auth., 2015 WL 7455557 (M.D. Tenn. Nov. 23, 2015); U.S. ex rel. Whipple v. Chattanooga-Hamilton Cnty. Hosp. Auth., 782 F.3d 260 (6th Cir. 2015); U.S. Whipple v. Chattanooga-Hamilton Cnty. Hosp. Auth., 2013 WL 4510801(M.D. Tenn. Aug. 26, 2013)
  • U.S. ex rel. Dennis v. Health Mgmt. Assocs., Inc. (M.D. Tenn.) We served as lead counsel representing a multi-­state hospital ownership company in a DOJ investigation of alleged FCA violations concerning physician relationships, which resulted in declination by DOJ and dismissal of relator’s claims following the granting of our client’s motion to dismiss.
    Reported Case: U.S. ex rel. Dennis v. Health Mgmt. Assocs., Inc., 2013 WL 146048 (M.D. Tenn. Jan. 14, 2013)
  • U.S. ex rel. Robinson v. Ardent Health Services (N.D. Ala.) We served as lead counsel representing a multi­-state hospital ownership company in a DOJ investigation of alleged FCA violations concerning inappropriate billing of hospital outpatient services in Oklahoma and New Mexico, which resulted in declination by DOJ and dismissal following the granting of our client’s motion to dismiss.
  • U.S. ex rel. McFeeters v. Northwest Hosp. (W.D. Tenn.) We served as lead counsel representing a Tucson, Arizona-based hospital in a lawsuit alleging FCA violations based on allegations of improper billing of Medicare for outpatient therapy services. Resulted in dismissal following the granting of our client’s motion to dismiss.
    Reported Case: U.S. ex rel. McFeeters v. Northwest Hosp., LLC, 2015 WL 328212 (M.D. Tenn. Jan. 23, 2015)
  • U.S. ex rel. Stratienko v. Chattanooga-Hamilton Cnty. Hosp. Auth. (E.D. Tenn.).  We represented a multi-state non-profit hospital system in FCA litigation concerning physician relationships, which resulted in declination by DOJ and dismissal of the underlying qui tam lawsuit after the filing of a motion to dismiss under the FCA’s public disclosure bar.
    Reported Case: U.S. ex rel. Stratienko v. Chattanooga-Hamilton Cnty. Hosp. Auth., 958 F. Supp. 2d 846, 849 (E.D. Tenn. 2013)

  • U.S. ex rel. Talbott v. ReVIDA Recovery Holdings (W.D. Va.) We served as lead counsel representing an office-based opioid treatment provider in an investigation by DOJ and Virginia and Tennessee under the FCA concerning billing for addiction treatment services, which resulted in declination by the government and voluntary dismissal by the relators following declination.
  • Representation of Addiction Treatment Facility. We serve as lead counsel representing an addiction treatment facility and its parent corporation in responding to a CID relating to state Medicaid and VA requirements and adequate documentation of services provided to patients.
  • U.S. ex rel. Cook v. Integrated Behavioral Health, Inc. (N.D. Ala.) We represent several skilled nursing facilities in FCA litigation alleging that the facilities engaged in a conspiracy with behavioral health providers to violate the AKS with respect to referrals concerning behavioral health services. The district court granted our clients’ motion to dismiss for failure to state a claim.
    Reported Case: United States ex rel. Cook v. Integrated Behavioral Health Servs., Inc., 2023 WL 2617399 (N.D. Ala. Mar. 23, 2023)
  • U.S. ex rel. McAllister v. Spero Health, Inc. (M.D. Tenn.) We served as lead counsel representing an addiction treatment company alleging that defendants prescribed Suboxone when not medically indicated, ordered unnecessary urine drug testing, and billed for higher levels of care than provided. We persuaded DOJ to decline intervention. The relator voluntarily dismissed the case.
  • U.S. ex rel. Joseph v. Brattleboro Retreat (D. Vt.) We served as lead counsel representing Brattleboro, Vermont-based not-for-profit in-patient addiction treatment facility in a qui tam lawsuit alleging FCA violations based on allegations that the provider submitted false claims for reimbursement to state and federal payers and by using internal accounting codes to mask alleged overpayments. The district court granted our client’s motion to dismiss, concluding that the relator failed to satisfy the pleading requirements of Rule 9(b) of the Federal Rules of Civil Procedure and that certain of the relator’s claims were time-barred. This district court’s opinion is one of the few reported decisions in the District of Vermont considering the pleading requirements for FCA violations.
    Reported Case: U.S. ex rel. Joseph v. Brattleboro Retreat, 2014 U.S. Dist. LEXIS 110153 (D. Vt. Aug. 10, 2014)
  • U.S. ex rel. Cederoth v. CRC Health Corp. (M.D. Tenn.) We served as lead counsel representing the owner of a substance abuse treatment facility in connection with a DOJ investigation and negotiation of successful resolution of FCA allegations concerning billing for the provision of substance abuse treatment and staffing and licensing issues. We negotiated a favorable settlement.
  • U.S. ex rel. Henry v. CRC Health Corp. (W.D. Tex.) We served as lead counsel representing a behavioral health provider in an FCA lawsuit involving allegations of improper billing for medications. We ultimately obtained dismissal of the substantive FCA allegations.

  • U.S. ex rel. Khoury v. Mountain West Anesthesia (D. Utah) We represent a physician practice group in connection with a qui tam lawsuit alleging that physicians failed to follow anesthesia billing requirements. This matter is ongoing.
  • U.S. ex rel. Rosenberg v. MetroDerm, P.C. (N.D. Ga.) We served as lead counsel representing a dermatology practice in connection with an FCA lawsuit involving allegations that the practice performed medically unnecessary procedures. We obtained a favorable settlement on behalf of our client during the pendency of our client’s motion to dismiss.
  • Physician Practice AKS/Lab Testing Matter (D.S.C.) We represented a South Carolina-based physician practice in connection with a DOJ investigation concerning alleged violations of the Anti-Kickback Statute related to laboratory testing. After an extensive investigation, we obtained a favorable settlement on behalf of our client.
  • Faber v. Mountain States Physician Group (W.D. Va.) We served as lead counsel representing a hospital company in connection with a lawsuit alleging FCA retaliation claims. The district court entered summary judgment on behalf of our client.
    Reported Cases: Faber v. Mountain States Physician Group, 2021 WL 6112614 (W.D. Va. Dec. 27, 2021); Faber v. Mountain States Physician Group, 2022 WL 16646667 (4th Cir. Nov. 3, 2022)
  • U.S. ex rel. Taylor v. Boyko (S.D. W. Va.). We served as lead counsel representing an emergency department provider and other defendants in a qui tam lawsuit alleging that violation of licensure laws caused submission of false claims. The district court dismissed the allegations against the emergency department provider on the grounds that the alleged regulatory violation did not satisfy standard for FCA materiality set forth in Supreme Court’s Escobar decision.
    Reported Cases: U.S. ex rel. Taylor v. Boyko, 2019 WL 2423283 (S.D. W. Va. Jun. 6, 2019); U.S. ex rel. Taylor v. Boyko, 39 F.4th 177 (4th Cir. 2022)
  • U.S. ex rel. Chihi v. Catholic Hospitals (S.D. Tex.) We represented an anesthesiology practice in FCA litigation asserting violations of the AKS, which resulted in voluntary dismissal of claims asserted against our client following the filing of a motion to dismiss.
  • U.S. ex rel. Nix v. United Biologics, LLC (N.D. Ga.) We served as lead counsel representing three HCA affiliated physician practice groups in an FCA lawsuit alleging kickbacks related to allergy shots. Resulted in dismissal following a motion to dismiss.
  • U.S. ex rel. Odom v. Southeast Eye Specialists, PLLC (M.D. Tenn.) We represented a specialty eye-care practice and related ASCs in connection with a DOJ investigation of alleged FCA violations and related FCA litigation concerning alleged violations of the AKS with respect to co-managed surgeries. In a first-of-its-kind ruling, we defeated the government’s motion for late intervention into the matter following its declination decision. Following extensive discovery, a settlement was reached in this matter.
    Reported Case: U.S. ex rel. Odom v. Southeast Eye Specialists, PLLC, 570 F. Supp. 3d 561 (M.D. Tenn. 2021)
  • Intraoperative Neuromonitoring Company. We served as lead counsel representing the largest independent intraoperative neuromonitoring service provider in connection with a multi-year company-wide FCA investigation by DOJ concerning interpretation and application of CMS billing codes related to IONM services provided by the company. We negotiated a successful settlement on behalf of the company, which included no administrative remedies.
  • U.S. ex rel. Stone v. Traverse Anesthesia Assoc. (TAA), PhyMed, (W.D. Mich.) We served as lead counsel in representing an anesthesiology management company in a DOJ investigation of FCA allegations alleging fraudulent billing for medically-directed services, which resulted in declination by DOJ and negotiation of successful resolution of remaining allegations.
  • U.S. ex rel. Cleland v. Pain Management Group, P.C. (M.D. Tenn.) We served as lead counsel representing a physician pain management practice in a DOJ investigation concerning FCA allegations that the practice engaged in fraudulent billing practices, which resulted in declination by DOJ and negotiation of a favorable settlement on behalf of our client.
  • Fakorede v. Mid-South Heart Center, P.C. (W.D. Tenn.) We served as lead counsel representing a physician practice group concerning allegations of retaliation under the FCA, which resulted in dismissal following a motion to dismiss with the decision affirmed on appeal.
    Reported Cases: Fakorede v. Mid-South Heart Center, P.C., 182 F. Supp. 3d 841 (W.D. Tenn. Apr. 26, 2016); Fakorede v. Mid-South Heart Center, P.C., 709 Fed. Appx. 787 (6th Cir. 2017)
  • Orthopedic Physician Practice Group. We served as lead counsel representing a Fairfax, Virginia-based orthopedic physician practice group in connection with a DOJ investigation of alleged violations of the FCA and Food, Drug and Cosmetic Act. This case resulted in declination of criminal enforcement under the FDCA and civil enforcement under the FCA.
  • Specialty Practice Clinic. We represented a specialty practice clinic investigated by a U.S. Attorney’s Office in the Northern District of Mississippi for Medicare billing fraud originating from a contractor audit. The contractor referred the case to the U.S. Attorney’s Office to investigate suspicions of possible civil or criminal healthcare fraud, including possible FCA liability. Following numerous meetings with the AUSA, the Government decided not to pursue any fraud claims against the specialty clinic. On administrative appeal, we were successful in reducing the $1.8 million overpayment demand to $0.
  • Addiction Medicine Physician Practice Group. We serve as lead counsel for a Florida-based addiction medicine physician practice group under criminal investigation by DOJ for, among other things, allegedly committing healthcare fraud. Over the course of the engagement, we have aided in responding to multiple subpoenas from the U.S. Attorney’s Office, engaged in negotiations with DOJ, and analyzed the physician’s practice model and business relationships. The matter is ongoing.

  • U.S. v. Medlock (M.D. Tenn.) We represented the owner of an ambulance company in a federal criminal jury trial and obtained appellate reversal of aggravated identity theft conviction.
    Reported Case: U.S. v. Medlock, 792 F.3d 700 (6th Cir. 2015)
  • U.S. ex rel. Cheshire v. Air Methods Corp. (W.D. La.) We represented an air ambulance company, in connection with an FCA lawsuit concerning alleged false billings for air ambulance services. Resulted in dismissal following a motion to dismiss.

  • U.S. ex rel. Waters v. Envision Healthcare Corp. We represented an owner of ambulatory surgery centers in connection with a qui tam lawsuit alleging that the ASCs violated the AKS by requiring CRNAs to accept a per diem rate for their services below revenue generated from those services and providing kickbacks to the physicians who ordered those services. The district court dismissed the relator’s complaint, determining that the allegations were barred under the FCA’s public disclosure bar.
    Reported Case: U.S. ex rel. Waters v. Envision Healthcare Corp., 2023 WL 2636461 (E.D. Cal. Mar. 24, 2023)
  • U.S. ex rel. Dalitz v. AmSurg Corp. (C.D. Cal.) We served as lead counsel for the nation’s largest owner and operator of ambulatory surgery centers in an FCA lawsuit alleging false claims resulting from failure to comply with regulatory requirements governing completion of histories and physicals. After significant litigation, we negotiated a favorable settlement.
    Reported Case: U.S. ex rel. Dalitz v. AmSurg Corp. 2014 WL 7336671 (C.D. Cal. Dec. 24, 2014)
  • U.S. ex rel. Simmons v. Meridian Surgical Partners, LLC (M.D. Tenn.) We represented an ambulatory surgery center owner and operator in a DOJ investigation regarding alleged false claims stemming from alleged AKS violations. After declination by DOJ and significant litigation, we negotiated a favorable settlement.
    Reported Case: U.S. ex rel. Simmons v. Meridian Surgical Partners, LLC, 2013 WL 4098663 (M.D. Tenn. May 2, 2013)
  • U.S. ex rel. Vanasco v. AHP of Orlando, LLC (M.D. Fla.) We represented an ambulatory surgery center owner and operator in a DOJ investigation of alleged FCA violations stemming from alleged AKS violations, which resulted in declination by DOJ and voluntary dismissal by the relator.
  • U.S. ex rel. Hughes v. Maury Regional Medical Center (M.D. Tenn.) We served as lead counsel for an ambulatory surgery center in connection with FCA litigation in which we negotiated a favorable settlement on behalf of our client.

  • U.S. ex rel. Haggard v. Diversicare Mgmt. Services, Co. et al. (M.D. Tenn.) & U.S. ex rel. Fitzmorris v. Diversicare Health Services, Inc. (M.D. Tenn.) We represented a publically traded long-term care corporation in a company-wide investigation by DOJ under the FCA concerning the reasonableness and medical necessity of therapy services and issues with pre-admission evaluation forms required by TennCare and PASRR forms. We negotiated a successful resolution of the FCA allegations and a favorable settlement for our client.
  • U.S. ex rel. Wright v. Saber Healthcare Holdings LLC (E.D. Va.) We served as lead counsel representing one of the largest privately-held skilled nursing facility companies in the country in connection with a company-wide DOJ investigation and negotiation of a successful resolution limited to fewer than 10% of company-affiliated skilled nursing facilities.
  • U.S. ex rel. Ernst v. College Park Ancillary, LLC (D. Kan.) We represent a former provider of outpatient therapy services in connection with an FCA lawsuit alleging violations of therapy billing requirements. We obtained dismissal of certain entities and certain allegations and negotiated a favorable settlement following discovery.
    Reported Cases: U.S. ex rel. Ernst v. College Park Ancillary, LLC, 2021 WL 5415868 (D. Kan. Nov. 19, 2021); U.S. ex rel. Ernst v. College Park Ancillary, LLC, 2021 WL 533830 (D. Kan. Feb. 12, 2021); U.S. ex rel. Ernst v. College Park Ancillary, LLC, 2020 WL 6868775 (D. Kan. No. 23, 2020).
  • U.S. ex rel. Herbold v. Nurse on Call, Inc. (M.D. Fla.) We served as lead counsel representing a home health company in a DOJ investigation and negotiated a successful resolution of FCA allegations that the company entered into questionable medical director agreements with physicians in exchange for the physicians referring patients to the agency.
  • U.S. ex rel. Hinkle v. Caris Healthcare, L.P. (E.D. Tenn.) We served as lead counsel representing a multi-state hospice provider in a DOJ investigation of alleged FCA violations concerning the medical necessity of hospice services. Following DOJ intervention and extensive litigation, we negotiated favorable settlement with no payment of attorneys’ fees to relator and no imposition of administrative remedies.
    Reported Case: U.S. ex rel. Hinkle v. Caris Healthcare, L.P., 2017 WL 3670652 (E.D. Tenn. May 30, 2017)
  • U.S. ex rel. Jenkins v. Weston Paxxon Sr. Rehab. Servs., LLC (N.D.N.Y.) We served as lead counsel representing a senior living company in a DOJ investigation involving FCA allegations that therapy-services company provided free services and leased space in communities at above fair market value in exchange for therapy referrals, which resulted in declination by DOJ and voluntarily dismissal of all FCA allegations against our client.
  • U.S. ex rel. Spencer et al. v. Emeritus Corp. (M.D. Fla.) We served as lead counsel representing a home health company in a DOJ investigation involving FCA allegations that home health agencies hired marketers who were married to physicians and that medical directors signed plans of care for patients for whom the medical director was not the patient’s attending physician, which resulted in a favorable settlement on behalf of our client.
  • U.S. ex rel. Newby v. Innovate Rehab and Wellness (W.D. Mo.) We represented a therapy company in a DOJ investigation of FCA allegations concerning the medical necessity of therapy services, which resulted in declination by DOJ.
  • U.S. ex rel. Prather v. Brookdale Senior Living Communities, Inc. (M.D. Tenn.) We served as lead counsel representing a home health company in extensive litigation concerning company-wide FCA litigation alleging that the company billed Medicare for home health claims where it had failed to obtain timely physician signatures on home health certifications. The district court dismissed the lawsuit for failure to plead that lack of timely signatures was material to the payment of claims as required under Escobar. The U.S. Court of Appeals for the Sixth Circuit reversed the dismissal 2-1 and the Supreme Court denied to grant certiorari. After remand, we aggressively sought discovery from CMS relating to past payment practices of home health claims, which ultimately led to the relator voluntarily dismissing the case.
    Reported Cases: U.S. ex rel. Prather v. Brookdale Senior Living Communities, Inc., 2015 WL 6812581 (M.D. Tenn. Nov. 5, 2015); U.S. ex rel. Prather v. Brookdale Senior Living Communities, Inc., 838 F.3d 750 (6th Cir. 2016); U.S. ex rel. Prather v. Brookdale Senior Living Communities, Inc., 265 F. Supp. 3d 782 (M.D. Tenn. 2017); U.S. ex rel. Prather v. Brookdale Senior Living Communities, Inc., 892 F.3d 822 (6th Cir. 2015)
  • U.S. ex rel. Tober v. Global Empire, LLC (D. Md.) We served as lead counsel representing a consultant to skilled nursing facilities in connection with a DOJ investigation of alleged FCA violations concerning medical necessity of therapy services, which resulted in negotiation of a favorable settlement with no payment of attorneys’ fees to relator or imposition of administrative remedies.
  • U.S. ex rel. Anderson v. Alive Hospice (M.D. Tenn.) We served as lead counsel representing a not-for-profit hospice company in a DOJ investigation involving FCA allegations that the company billed for hospice services that were not medically necessary, which resulted in negotiation of a favorable settlement on behalf of our client.
  • U.S. ex rel. White v. Gentiva Health Services, Inc. (E.D. Tenn.) We served as lead counsel representing a home health company in an FCA lawsuit alleging false claims in connection with medically unnecessary home health services, which resulted in dismissal of four of five alleged fraud schemes following a motion to dismiss and negotiation of favorable settlement of the remaining claim.
    Reported Case: U.S. ex rel. White v. Gentiva Health Services, Inc., 2014 WL 2893223 (E.D. Tenn. June 25, 2014)
  • U.S. ex rel. Byrd v. National HealthCare Corp. (E.D. Tenn.) & U.S. ex rel. Forsythe v. National HealthCare Corp. (E.D. Tenn.) We served as lead counsel representing one of the largest owners and operators of skilled nursing facilities in connection with a DOJ investigation of alleged FCA violations concerning the medical necessity of therapy services, which resulted in declination by DOJ and voluntary dismissal by DOJ and relators.

  • U.S. ex rel. Osheroff v. Healthspring, (M.D. Tenn.) We served as lead counsel representing a publicly-traded managed care organization in a DOJ investigation involving FCA allegations concerning alleged AKS violations and alleged violations of rules governing the marketing of Medicare Managed Care Organizations, which resulted in declination by DOJ and granting of our client’s motion to dismiss relator’s FCA claims.
    Reported Case: U.S. ex rel. Osheroff v. Healthspring, 938 F. Supp. 2d (M.D. Tenn. 2013)
  • U.S. ex rel. Ramsey v. Censeo Health, L.L.C. (N.D. Tex.) We served as lead counsel representing a Medicare Advantage service provider in a qui tam lawsuit alleging that defendants violated the FCA by causing the inflation of risk adjustment scores, which resulted in negotiation of a favorable settlement on behalf of our client.
  • U.S. ex rel. Derrick v. Roche Diagnostics Corp. (N.D. Ill.) We serve as lead counsel representing a managed care provider and its diagnostics and treatment affiliate in a DOJ investigation involving allegations that the company violated the FCA by engaging in a kickback scheme, which resulted in declination by DOJ and on-going litigation with the relator.

  • U.S. ex rel. Hoffman v. CDL Nuclear Technologies (S.D.N.Y.) We represented a supplier of nuclear imaging equipment and related supplies in a DOJ investigation concerning alleged violations of the Anti-Kickback Statute. We obtained declination on behalf of our client with respect to DOJ and the relators voluntarily dismissed the action following declination.
  • U.S. ex rel. Grogan v. Innovative Therapies, Inc. (M.D. Tenn.) We represented a durable medical equipment manufacturer in a DOJ investigation into alleged FCA violations concerning the manner in which certain negative pressure wound therapy devices were being marketed and distributed as durable medical equipment, which resulted in a favorable settlement for our client.
  • U.S. ex rel. Hobbs v. MedQuest Assocs. (M.D. Tenn.) We represented a Georgia-based owner of diagnostic imaging facilities in FCA litigation in which DOJ had intervened, which resulted in an opinion by the U.S. Court of Appeals for the Sixth Circuit reversing the district court and entering summary judgment on behalf of MedQuest and against United States.
    Reported Case: U.S. ex rel. Hobbs v. MedQuest Assocs., 711 F.3d 707 (6th Cir. 2013)
  • U.S. ex rel. Holderith v. One Step Diagnostics, Inc. (S.D. Tex.) We represented a Houston, Texas-based imaging services provider in connection with a DOJ investigation of FCA allegations regarding the propriety of payments for medical directorships, which resulted in negotiation of a favorable settlement on behalf of our client.
  • United States v. ArthroCare Corp. (W.D. Tex.) We represented a developer and manufacturer of surgical devices and implants, in a five-year DOJ securities fraud investigation into whether senior executives defrauded investors. ArthroCare agreed to pay $30 million and entered into a deferred prosecution agreement to end the investigation. The $30 million represented an almost 50% reduction of the amount of fine that could have been levied against the company under the U.S. Sentencing Guidelines due to its extensive remedial and cooperation efforts. Furthermore, DOJ did not require a monitor.

  • U.S. ex rel. Hueseman v. PSI (W.D. Tex.); U.S. ex rel. Sten v. Midwest Compounders (N.D. Iowa) We served as lead counsel representing a national pharmaceutical ingredient supplier and its wholly-owned subsidiaries in a DOJ investigation of alleged FCA violations concerning inflated Average Wholesale Prices, kickbacks to physicians, and waivers of co-pays. After a several-year investigation based on the filing of four separate qui tams, we negotiated a successful resolution of the litigation that was substantially less than the government’s alleged damages.
  • Pharmaceuticals Developer. We serve as compliance and investigations counsel representing a pharmaceuticals developer in connection with several investigations involving a combination of document review, witness interviews, and internal reporting. Upon conclusion of each internal investigation, we helped determine whether the misconduct rose to the level of a “reportable event” under the client’s CIA and when necessary assisted with preparation of the reportable event disclosure to HHS-OIG.
  • Medical Device Company. We serve as compliance and investigations counsel representing the world’s largest medical device company in connection with investigations involving extensive witness interviews and document review. The types of alleged conduct investigated involve alleged violations of federal and state law, as well as internal compliance policies, including investigating the relationship and interactions between sales representatives and physicians, product marketing, product development, educational funding, and reimbursement.
  • Pharmaceutical Services Provider. We represented a pharmaceutical services provider in a criminal and civil investigation involving the U.S. Attorney’s Office for the District of Massachusetts. The investigation concerned the relationship and interactions between the client’s, pharmaceutical manufacturers, and charitable patient assistance programs for prescription drugs.

  • U.S. ex rel. McClain v. Nutritional Support Services, L.P. (D.S.C.) We served as lead counsel representing a long-term care pharmacy in connection with a qui tam lawsuit alleging violations of the FCA based on allegations that the pharmacy improperly billed Medicare and state Medicaid programs for drugs dispensed in skilled nursing facilities. The district court granted our client’s motion to dismiss, concluding that the relator’s complaint failed to plead falsity and materiality under the FCA and failed to plead in accordance with Rule 9(b). The district court also dismissed the relator’s retaliation claims.
    Reported Case: U.S. ex rel. McClain v. Nutritional Support Services, L.P., 2020 WL 2464655 (D.S.C. Mar. 16, 2020)
  • U.S. ex rel. Strauser v. Stephen L. LaFrance Holdings, Inc., (N.D. Okla.) We serve as lead counsel representing the former owners of a multi-state retail pharmacy chain in connection with a DOJ investigation regarding alleged violations of the FCA resulting from inaccurate reporting of usual and customary pricing of generic drugs, which resulted in declination by DOJ. Following discovery and briefing on motions for summary judgment, a settlement was reached in this matter.
  • U.S. ex rel. Phillips v. Stephen L. LaFrance Holdings, Inc. (N.D. Okla.) We served as lead counsel representing the former owners of a multi-state retail pharmacy chain in connection with a DOJ investigation regarding alleged violations of the FCA resulting from inaccurate reporting of usual and customary pricing of generic drugs, which resulted in declination by DOJ and dismissal of the underlying qui tam lawsuit after the filing of a motion to dismiss under the FCA’s first-to-file rule.
    Reported Case: U.S. ex rel. Phillips v. Stephen L. LaFrance Holdings, 2018 WL 4839057 (N.D. Okla. Oct. 4, 2018)