Brian Roark on Healthcare Fraud for American Medical News

February 1, 2010
American Medical News

Brian Roark, attorney at Bass, Berry & Sims, is extensively quoted in the February 1, 2010 edition of American Medical News regarding a recent 9th U.S. Circuit Court of Appeals decision. The ruling overturned a rare award to a physician for legal fees he spent defending himself in what turned out to be a failed healthcare fraud prosecution. The article is titled “Fraud Charges Dropped, But Doctor Can’t Recoup Costs.”

From the article:

“Here the government brought a criminal action, saying these procedures are not medically necessary, which often comes down to a difference of opinion, and unfortunately that’s becoming a criminal action,” said Nashville, Tenn., attorney Brian D. Roark, who defends physicians in health care fraud matters.

The 9th Circuit’s reversal came as no surprise because frivolous claims are difficult to prove, he said, and the ruling serves as a grave reminder that physicians have little recourse against the government.

“The hope is, if the government is going to pursue something criminally, it only does so after careful consideration because the risk to the defendant is so great,” said Roark, of Bass, Berry & Sims, adding that physicians face anything from fines to jail time to exclusion from federal health care programs.

“Generally, the physician has no option other than to try and settle and work it out. … So at the first sign of any government inquiry, the physician needs to move quickly to resolve it, and the government is always willing to have a back-and-forth.”