Represented the former CEO of a leading regional health care provider in a federal
health care fraud investigation.
Represented a national health care provider in a federal
health care fraud investigation concerning allegations of overbilling and beneficiary inducement.
Have you become the target of
a health care fraud investigation?
The commenters identified particular factors that could lead to confusion, including that (1) the phrase «criminal, civil, or administrative proceeding» appeared in the definitions of both law enforcement Start Printed Page 82673and oversight; (2) the examples of oversight agencies listed in the preamble included a number of organizations that also conduct law enforcement activities; (3) the NPRM addressed the issue of disclosures to investigate health care fraud in the law enforcement section (§ 164.510 (f)(5)-RRB-, yet
health care fraud investigations are central to the mission of some health care oversight agencies; (4) the NPRM established more stringent rules for disclosure of protected health information pursuant to an administrative subpoena issued for law enforcement than for disclosure pursuant to an oversight agency's administrative subpoena; and (5) the preamble, but not the NPRM regulation text, indicated that agencies conducting both oversight and law enforcement activities would be subject to the oversight requirements when conducting oversight activities.
To clarify further that health oversight disclosure rules apply generally in
health care fraud investigations (subject to the exception described above), in the final rule, we eliminate proposed § 164.510 (f)(5)(i), which would have established requirements for disclosure related to health fraud for law enforcement purposes.
Specifically, this overlap occurred because: (1) The NPRM preamble, but not the NPRM regulation text, indicated that agencies conducting both oversight and law enforcement activities would be subject to the oversight requirements when conducting oversight activities; and (2) the NPRM addressed some disclosures for investigations of health care fraud in the law enforcement paragraph (proposed § 164.510 (f)(5)(i)-RRB-, while
health care fraud investigations are central to the purpose of health care oversight agencies (covered under proposed § 164.510 (c)-RRB-.
To clarify further that health oversight disclosure rules apply generally in
health care fraud investigations (subject to the exception described above), in the final rule, we eliminate proposed § 164.510 (f)(5)(i), which would have established requirements for disclosure related to health care fraud for law enforcement purposes.
Not exact matches
Merida
Health Care Group closed its Corona Drive location last week after a slew of legal troubles linked to a
fraud and money laundering
investigation.
Ed has represented engineering firms,
health care companies, and defense firms in grand jury
investigations into alleged
fraud in their business dealings with the federal government and other public entities.
The return on
investigation investment suggests that the federal government's interest in investigating and prosecuting
health care fraud and abuse is substantial.
She has experience in handling
investigations and prosecutions brought under a wide variety of federal criminal statutes, including banking
fraud,
health care fraud, bitcoin schemes, computer crimes, securities
fraud, mail and wire
fraud schemes, Ponzi schemes, insider trading, government contracting
fraud, commercial bribery, Anti-Money-Laundering violations, and conspiracy offenses.
In addition, Mr. Cloherty represents businesses and individuals in enforcement matters and government
investigations stemming from
health care, securities, and mail and bank
fraud allegations.
She also represents clients in government
investigations relating to
health care fraud and abuse, and defending False Claims Act cases.
Whether you are under
investigation or have been charged, you need a
health care fraud defense attorney on your side now.
Accusations of
health insurance
fraud or
health care fraud demand an experienced criminal defense attorney with sophisticated knowledge of
health care law,
investigation procedures and complex medical coding practices.
With extensive knowledge in a variety of white collar defense matters, and an emphasis on
health care and securities enforcement, Mateja joins the firm's national White Collar Defense & Government
Investigations Practice Group, and will also focus heavily on
health care fraud and abuse matters.
Henry Fenton, Alexandra de Rivera, Dennis Lee, and Herb Weinberg successfully represented INF Corporation, dba Star Pharmacy, in a
fraud investigation in front of the California Department of
Health Care Services (DHCS).
Selesnick and Medina also defend providers in government
investigations for
fraud and abuse, and routinely represent
health care providers in complex business disputes.
Federal crimes such as bank robbery, kidnapping,
health care fraud, mortgage
fraud, insurance and securities
fraud, and child pornography possession are often the result of long - term
investigations that involve multiple interviews and searches.
He has represented
health care providers in government and internal
investigations of alleged
fraud and abuse.
The firm offers top - quality legal services in the following practice areas: clinical negligence and personal injury, community
care and
health services, criminal law, discrimination and equality law, employment law and professional discipline, family and matrimonial law, housing, human rights, public law and judicial review, immigration, inquests and inquiries, international law, media and information law, reputation and crisis management, mental
health, police misconduct, prison law, professional negligence, public procurement and commercial reputation, serious
fraud and regulatory
investigations and Brexit.
Conducted an internal
investigation into allegations of financial accounting
fraud on behalf of the audit committee of a publicly traded
health care corporation.
Investigation of $ 300 million alleged
health care fraud by high ranking officials in a prominent national
health care company
From
health care transactions and regulatory counseling to
fraud and abuse
investigations, from the defense of government enforcement actions to political advocacy and lobbying, Bryan Cave provides comprehensive and robust solutions to complicated and challenging
health care matters.
As Counsel to the Chief of the Justice Department, he aided in the oversight of more than 100 prosecutors working on Foreign Corrupt Practices Act, securities,
health care, and other
fraud investigations and cases.
We believe that
investigations involving
health care fraud represent
health oversight rather than law enforcement.
In such cases, where the individual is the subject of the
investigation and the
investigation does not relate to
health care fraud, identified as
investigations regarding issues (a) through (c), the rules regarding disclosure for law enforcement purposes (see § 164.512 (f)-RRB- apply.
This section indicates that
health oversight activities do not include an
investigation or activity in which the individual is the subject of the
investigation or activity and the
investigation or activity does not arise out of and is not directly related to
health care fraud.
Accordingly, under the final rule, in joint law enforcement / oversight
investigations involving suspected
health care fraud, the
health oversight disclosures apply, even if the individual also is the subject of the
investigation.
Where the individual is not the subject of the activity or
investigation, or where the
investigation or activity relates to
health care fraud, a covered entity may make a disclosure pursuant to § 164.512 (d)(1), allowing uses and disclosures for
health oversight activities.
Comment: Many commenters noted that proposed § 164.510 (f)(5)(i), which covered disclosures for
investigations and prosecutions of
health care fraud, overlapped with proposed § 164.510 (c) which covered disclosures for
health oversight activities.
For the purposes of this rule, we intend for
investigations regarding issues (a) through (c) above to mean
investigations of
health care fraud.
High - stakes products litigation typically requires our clients to mount their defense on multiple fronts, which may include class action litigation, multidistrict litigation, individual personal injury actions at the state and federal level, consumer
fraud actions, actions by
health care providers, False Claims Act litigation, actions by state attorneys general, government
investigations, and internal reviews.
We have both conducted internal
investigations regarding and defended clients against, allegations of
health care, securities and government contract
fraud; the Foreign Corrupt Practices Act («FCPA»), Corruption, Money Laundering and Trade Sanctions, Economic Espionage and Trade Secrets, Tax Evasion,
Fraud, Asset Forfeiture, Employment and Immigration Issues, Environmental Violations, Anti-Kickback Statute and False Claims Act, and Criminal Antitrust Price Fixing.