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Fraud and abuse counseling, defense, prevention and compliance

Porter Wright attorneys are widely recognized as some of the leading attorneys on health care fraud and abuse matters due to the depth of their experience. Our attorneys advise a wide variety of health care organizations to structure business arrangements that comply with the Stark law, state anti-referral laws and federal and state anti-kickback laws, civil money penalty laws and the federal False Claims Act. In addition to structuring new compliant business arrangements, we analyze existing business arrangements for potential violations of the fraud and abuse laws and develop strategies for addressing past violations. We also regularly defend our clients in civil and criminal investigations of alleged health care fraud and abuse.

Our attorneys have significant experience in the development and implementation of compliance programs that follow applicable guidelines established by governmental agencies, including pronouncements by the OIG, as well as ethical guidelines and directives established by non-governmental organizations such as the AdvaMed Code and PhRMA Code. Our compliance programs are designed and developed to address the risks presented by the client’s business, but tailored to the organization’s culture and structure. We regularly monitor developments and pronouncements from federal and state agencies and their potential impact on clients’ compliance activities. We have developed and implemented compliance programs for a variety of health care providers, including hospitals and health systems, physicians and physician organizations, home health agencies, academic medical centers and faculty practice plans, and other ancillary service providers. We also regularly advise clients about voluntary disclosure of compliance issues to governmental and non-governmental payers.

Our attorneys are recognized for their experience in conducting internal investigations of and defending health care providers against allegations of fraud and abuse. We frequently represent corporate and individual providers in responding to grand jury subpoenas, DOJ and OIG investigations, criminal prosecutions and administrative proceedings. Our attorneys are frequently called upon by industry groups and trade associations to speak about current fraud and abuse enforcement trends by various federal and state agencies.