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Healthcare

WMH lawyers have handled a wide range of matters in the healthcare industry, both representing plaintiffs and defendants.  Through various types of litigation, our attorneys have developed significant experience in a number of substantive sub-specialties.

Representative Cases

  • Represent relator in qui tam action against hospital facility, which alleges violations of billing rules that apply to acute care facilities.
  • Represented Fortune 500 healthcare company in qui tam action. During representation, internal investigation determined that corporate subsidiary, which manufactured in vitro diagnostic devices, was found to have violated its own manufacturing guidelines and made various inaccurate marketing claims about its products.  Ultimately, Board of Directors agreed to close troubled subsidiary.  Subsidiary pled guilty to misleading marketing practices, and parent company settled federal and state inquiries for approximately $302m.
  • Represented private healthcare company that had been indicted for fraudulent Medicaid billing related to home health aide services allegedly provided by aides lacking necessary training. We assisted in bolstering company’s compliance policies and practices, and ultimately negotiated civil resolution for company.
  • In context of Department of Justice investigation over suspected collusion between managed care companies, devised enhancements to compliance program of Fortune 100 Company.
  • Represented various insurers to recover payments for medically unnecessary surgeries and drugs.
  • Represented dermatologist who was target of multi-year criminal health care fraud investigation involving upcoding and unbundling, being conducted by Federal Bureau of Investigation and United States Attorney’s Office for the Southern District of New York, obtaining declination after several written submissions and in-person presentations.
  • One of our attorneys previously served on Independent Monitorship team appointed pursuant to deferred prosecution agreement between Department of Justice and international medical device manufacturer to resolve claims in connection with Anti-Kickback Statute and False Claims Act. As part of monitorship, the WMH attorney helped oversee implementation of new corporate compliance procedures, including by conducting top-to-bottom review of medical device manufacturer’s compliance department; providing recommendations; and drafting and implementing new policies, certifications, and consulting agreements.
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