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Health Care Fraud & Abuse
Our lawyers cover the latest heath care law developments in our ongoing Triage podcast. Subscribe to Triage through iTunes or Google Play.

Members of our team publish the Qui Tam Quarterly newsletter highlighting emerging and pressing issue in health care fraud and abuse.

As one of the most heavily scrutinized industries in the U.S., health care has been and will remain a primary target for allegations of fraud and abuse. Fraud and abuse allegations expose those operating in the health care industry to government enforcement actions, qui tam lawsuits initiated by whistleblowers, significant civil and criminal liability, and potential exclusion from participation in federal health care programs. When health care fraud and abuse matters arise, health care professionals need a legal team that possesses sophisticated defense skills on both the civil and criminal fronts, as well as a deep understanding of health care laws and regulations. The K&L Gates Health Care Fraud & Abuse group is uniquely positioned to defend health care clients when the stakes are at their highest and when results are critical.

The K&L Gates Health Care Fraud & Abuse group is a powerful combination of lawyers from our Investigations, Enforcement and White Collar and Health Care practice groups, supported as necessary by the firm’s e-Discovery Analysis and Technology (e-DAT) group. This collaboration offers us a unique perspective that informs and drives the defense strategies and teams deployed for our clients. Consisting of former U.S. Attorneys and Assistant U.S. Attorneys, as well as lawyers with significant experience handling the most sophisticated health care regulatory matters, the K&L Gates Health Care Fraud & Abuse group is equipped to help clients navigate the inherent complexities and challenges of health care fraud and abuse investigations, including those associated with electronically stored information and electronic medical records. With team members located in our offices across the country and in virtually every region, the Health Care Fraud & Abuse group is able to meet our health care clients’ needs wherever, whenever, and however they arise.

The K&L Gates Health Care Fraud & Abuse group routinely represents health care systems, hospitals, providers, and companies across the health care industry. These matters include investigations and litigation related to (1) the False Claims Act (“FCA”), including actions initiated by the government and through qui tam or whistleblower lawsuits; (2) the Stark Law and the Anti-Kickback Statute; (3) the federal Food, Drug, and Cosmetic Act; and (4) Medicare and Medicaid audits, including RAC and ZPIC audits. The K&L Gates Health Care Fraud & Abuse group also has significant experience handling Office of Inspector General (“OIG”) Self-Disclosures and helping clients navigate the Centers for Medicare & Medicaid Services (“CMS”) Voluntary Self-Referral Disclosure Protocol.

As health care laws, regulations, and legal precedent continuously develop, our lawyers stay abreast of such changes to ensure we maintain the strongest institutional knowledge and legal skills to meet our clients’ unique needs.

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Representation of both U.S. and international companies and executive officers in federal and state court cases, grand jury investigations, and criminal prosecutions involving a wide range of health care fraud and abuse matters.
Representation of a large university medical center in an FCA investigation and lawsuit alleging resident-attending supervision issues.
Representation of a major international pharmaceutical company under investigation by federal prosecutors for alleged wrongdoing in the dissemination of information on the safety and efficacy of pharmaceutical medications.
Representation of a drug manufacturer involved with issues surrounding certifications related to the new drug application process and the U.S. Food and Drug Administration (“FDA”).
Representation of hospice provider in a U.S. Department of Justice (“DOJ”)-intervened FCA case and investigation alleging the unlawful provision of hospice services to patients who were not terminally ill.
Representation of executive officer of pain-management practice in parallel criminal and civil proceedings spearheaded by the DOJ, alleging Anti-Kickback Statute violations and conspiracy.
Representation of pain-management practice in FCA action alleging medically unnecessary urine drug screens and the ordering and use of non-FDA approved and foreign-sourced drugs.
Representation of national testing laboratory in case involving alleged kickbacks and FCA violations.
Representation of a durable medical equipment (“DME”) company in connection with a federal investigation involving alleged Anti-Kickback Statute and FCA violations.
Representation of one of the world’s largest pharmaceutical companies in a more than five-year DOJ criminal and civil investigation into sales and marketing practices associated with a pain-relief drug. The criminal investigation was led by a U.S. attorney’s office, along with the U.S. Department of Health and Human Services (“HHS”)-OIG, the Federal Bureau of Investigation, and the DOJ’s Civil Division.