Regulatory Enforcement Action Cases

Healthcare Valuation Analysis for Corporate Integrity Agreement (CIA)

Retained to provide fair market value analysis by an outsourced provider of medical equipment as required for compliance under a CIA.

Healthcare False Claims Act Matter

Retained by counsel for the defendants in a False Claims Act matter which required an analysis of disputed claims, cost report data, peer group performance, business performance and owner compensation levels as key factors in the assessment of liability and damages. This case ultimately settled.

Governmental Dispute for Behavioral Health Facility

Provided damages calculation and expert consulting services on behalf of a behavioral health facility operator in a dispute with a municipality over withdrawn building and operating permits, resulting settlement favorable to our client.

Stark and Anti-Kickback Violations

Engaged through counsel to provide litigation support related to Stark and Anti-Kickback allegations.

Ability to Pay Analysis

Engaged by federal and state agencies to calculate the plaintiffs ability to pay overpayments, fines and penalties.

Qui Tam support involving billing/coding fraud allegations

Engaged by council of various healthcare companies to provide litigation support involving Qui Tam allegations of billing and/or coding fraud.

Restructuring engagement involving large urban hospital bankruptcy

Engaged to wind down a hospital, organize the transfer of patients, and prepare reports for bankruptcy filing.

Independent Review Organization

Engaged and approved by federal government to act as an Independent Review Organization (IRO) as part of a Corporate Integrity Agreement involving the False Claims Act.

Appeal RAC, ZPIC, and Other Payor Recoupments

Worked with providers auditing documentation and coding of medical records and work with council to appeal recoupments.

Search Site

Search Team

Search Articles