Successfully represented national hospice provider Aseracare in False Claims Act action tried in federal court which alleged the admission and recertification of patients who were not terminally ill. After 10 weeks of trial, the judge entered summary judgment for Aseracare. The United States appealed, resulting in September 2019 in a landmark 11th Circuit medical necessity opinion holding that a mere difference of physician expert opinions regarding the eligibility of a patient for hospice, without more, is insufficient to establish falsity under the False Claims Act.
Represented a home health provider in a federal criminal investigation alleging violations of the Anti-Kickback Statute, resulting in a declination of the criminal case and a resolution under the civil False Claims Act.
Representing a therapy services provider in relation to a Department of Justice and HHS OIG investigation under the Federal False Claims Act involving allegations of falsifying medical records in support of claims.
Conducted multitude of internal investigations for various hospitals into physician employment and other physician arrangements, including without limitation allegations relating to the Stark Law and Anti-Kickback statute. Many involved investigations by the Department of Justice and/or the HHS OIG.
Represented MetLife Bank during False Claims Act investigation into allegations of submission of false claims relating to FHA insured mortgages for single family homes. The matter settled with the Department of Justice and the HUD OIG in 2015 before the filing of a complaint.
Represented Amedisys, Inc. in relation to a major qui tam False Claims Act action alleging false claims relating to home health services. The case settled in 2014 before the unsealing of the qui tam
United States ex rel. Barbera v. Tenet Healthcare Corporation, No. 0:97-cv-06590-AJ (S.D. Fla.)
Defended numerous physicians employed by Florida hospital owned by Tenet Healthcare against qui tam whistleblower allegations brought under the Federal False Claims Act.
United States ex rel. Zeller v. Centex Corporation, 1:99-CV-00621-SJD
Successfully defended Centex Corporation against qui tam allegations of fraud against the Navy, resulting in a dismissal of the claims against Centex without liability.
United States ex rel. Wilson v. Callahan Eye Foundation Hospital, Case No. 2:03-CV-02533-KOB (N.D. Ala.)
Obtained summary judgment on behalf of defendants against False Claims Act qui tam allegations of Medicare fraud.
United States ex rel. Fender v. Tenet Healthcare Corporation et al., No. 2:98-cv-00899-JFG (N.D. Ala.)
Successfully defended numerous physicians employed by hospital owned by Tenet Healthcare against qui tam whistleblower allegations brought under the Federal False Claims Act, resulting in a dismissal of the action with no liability.
United States ex rel. Manning v. HealthSouth Corporation, 2:99-cv-02150-KOB (N.D. Ala.)
Defended HealthSouth in False Claims Act qui tam action alleging Medicare fraud.
United States ex rel. Colbert v. Blue Cross and Blue Shield of Alabama and HealthSouth Corporation, 2:01-cv-00292-UWC (N.D. Ala.)
Defended HealthSouth in False Claims Act qui tam action alleging Medicare fraud, resulting in the dismissal of the False Claims Act count and final joint stipulation of dismissal.
United States ex rel. Madrid v. HealthSouth Corporation, et al., 2:97-cv-03206-UWC (N. D. Ala.) Defended HealthSouth Corporation in False Claims Act qui tam action alleging Medicare fraud.
Internal investigation of oil company
Conducted an internal investigation during 2012-2014 for a major oil company regarding allegations of inappropriate relationships with public officials and voluntarily disclosed evidence to the government. No action taken against the client.
Defended against federal criminal charges
Defending interventional cardiologist on federal criminal charges of inserting coronary artery stents when medically unnecessary.
SEC v. HealthSouth Corporation and Richard M. Scrushy, No. CV-03-J-0615-S (N.D. Ala.), and parallel criminal investigation and proceedings (case settled as to HealthSouth)
Defended HealthSouth during federal criminal investigation into allegations of a massive financial fraud, resulting in a non-prosecution agreement. Also defended HealthSouth in parallel civil action brought by the Securities and Exchange Commission.
Representing government contractors in FCA-related claims
Representation of numerous government contractors in connection with various issues including false statements, false claims, kickbacks, and qui tam
United States v. McWane
Represented client in connection with environmental criminal case that was tried to verdict in federal district court in Alabama. Following conviction, worked on appeal to Eleventh Circuit that resulted in complete reversal of convictions. Matter was ultimately settled.
Represented county government in Clean Water Act investigation
Represented county government in connection with criminal Clean Water Act investigation. Criminal prosecution was declined and case closed.
Represented health system and hospital in qui tam whistleblower action
Represented a health system and an individual hospital in an unsealed qui tam action under the False Claims Act in which the government intervened, alleging a kickback scheme for referrals of obstetric services.
Represented hospital and hospital system in internal investigation
Represented hospital and hospital system in internal investigation in response to anonymous complaint letter regarding alleged test manipulation and Stark Law concerns with hospital employees’ outside work for local provider of durable medical equipment.
Represented hospital in data breach incident
Represented hospital, conducted internal investigation to determine root cause, and coordinated contact with law enforcement following the criminal theft of patient data and related identity theft issues.
Represented hospital in Justice Department inquiry into licensing regulations
Represented hospital in connection with Justice Department inquiry under the False Claims Act into licensing of sleep lab technician compliance with state licensing regulations.
Representing nationwide therapy services provider in Department of Justice investigation
Representing nationwide provider of therapy services at skilled nursing facilities in a Justice Department investigation into the medical necessity of services.