We have long represented providers of all types in major enforcement actions involving false billing, kickbacks, the Stark Law, the Beneficiary Inducement Statute, unnecessary services and quality of care. Among other matters:
- We have represented numerous hospitals in connection with government investigations relating to billing and Anti-Kickback Statute issues and handled a number of OIG self-disclosures for such entities.
- We represented two national for-profit long-term care companies in connection with numerous criminal and civil investigations related to alleged kickbacks, billing fraud and quality of care issues.
- We represented the nation’s largest for-profit provider of psychiatric services in numerous criminal and civil investigations relating to alleged kickbacks to physicians, billing improprieties and quality of care.
- We represented a multi-state Medicare Advantage provider in a government investigation into alleged upcoding, resulting in the first provider-side resolution of such claims under the False Claims Act.
- We represented national retail pharmacy chains in civil and criminal investigations involving allegations of violations of under the Controlled Substances Act, pricing at above usual and customary charges, and other issues.
- We represented a hospital pharmacy in a civil and criminal investigation, resulting in the first Non-Prosecution Agreement entered into by a pharmacy to resolve alleged violations of the Controlled Substances Act.
- We represented a non-emergency medical transportation provider in a state Medicaid investigation into inflated billing.
Conducted an internal investigation into alleged kickbacks relating to investment opportunities at ambulatory surgery centers.
We represented one of the nation’s most prominent DME suppliers in connection with a variety of federal investigations relating to billing for DME supplies. - Several lawyers in our group (prior to joining Sidley) represented a major dialysis provider in connection with what was (at the time) the largest healthcare fraud settlement as well as subsequent settlements with the U.S. Attorney’s Office in Boston.