Health care providers operate in one of the most highly-regulated industries in the country and are under intense scrutiny by government enforcement agencies. As recipients of federal funding from Medicare, Medicaid, TRICARE, and other federal health care programs, health care providers are often the subject of civil and criminal investigations and enforcement actions initiated by the Centers for Medicare and Medicaid Services (CMS), Department of Health and Human Services Office of Inspector General (HHS-OIG), Department of Justice (DOJ), Office of Civil Rights (OCR), Federal Bureau of Investigation (FBI), state Medicaid Fraud Control Units (MFCUs), and state attorneys general. Led by a former Chief of Fraud and Corporate Neglect Investigations for the Virginia Attorney General and Special Assistant U.S. Attorney, HDJN’s Healthcare Investigations and Enforcement Actions team represents organizational and individual health care providers in all stages of regulatory investigations, complex federal and state civil and criminal investigations, and related litigation.
Healthcare Investigations and Enforcement Actions Services:
- Defending health care providers under investigation by HHS-OIG, DOJ, FBI, OCR, and other state and federal agencies
- Civil False Claims Act and Whistleblower (qui tam) investigations and defense
- Conducting internal investigations in response to fraud or potential whistleblower allegations
- Self-disclosures to HHS-OIG, DOJ, and other regulators
- CMP demands and threatened litigation
- Coordinating responses to administrative and regulatory inquiries to protect providers from related or parallel civil and criminal enforcement actions