Comprehensive solutions for complex challenges
Navigating the healthcare disputes landscape can be a complex journey.
We assist payors, physician platforms, pharmacies, disease management companies, healthcare technology companies, and private equity investors through the complexities of healthcare disputes.
Our deep industry knowledge allows us to craft practical solutions for your most challenging disputes. Members of our team – which include lawyers from DLA Piper’s Regulatory and Government Affairs and Litigation, Arbitration, and Investigations teams– have served in senior positions at the Centers for Medicare & Medicaid Services (CMS), , the Food and Drug Administration (FDA), as well as federal and state prosecutors and senior in-house counsel.
“DLA Piper's team has in-depth technical subject matter expertise coupled with practical experience and approaches.”
We work with our clients to develop and defend compliant revenue maximization strategies, helping them maintain profitability and compliance throughout the business lifecycle.
Our experience representing clients in multiple areas includes responding to regulatory challenges, resolving government investigations, defending single plaintiff and class action litigation, prosecuting affirmative litigation, and reducing risk.
Awards and recognition
Experience
Healthcare litigation
- Prosecuted a USD150 million claim for a service provider against a health plan over amounts allegedly due under a risk-sharing arrangement
- Successfully defended a pharmacy in a Racketeer Influenced and Corrupt Organizations (RICO) action. The pharmacy was alleged to have improperly purchased a health insurance plan for outsourced employees
- Prosecuted claims and recovered more than USD30 million for a private equity fund against a physician who allegedly committed fraud
- Assessed litigation options and advised a large health system on potential challenges to a state regulation that would have targeted its revenue streams but not those of its competitors
- Defending a payor in defamation litigation brought by the owners of laboratories who were federally prosecuted for fraud
Healthcare investigations
- Resolved a high-profile False Claims Act case for a large health system
- Conducted an investigation in response to a CMS-filed whistleblower complaint regarding the sale of Medicare policies by licensed agents
- Successfully resolved a state attorney general investigation into a specialty pharmacy’s opioid dispensing and sales marketing practices
Medicare and Medicaid audits
- Successfully worked with CMS to revise coverage policies and resolve complex compliance issues for a client
- Routinely counsel on reimbursement implications related to contractual arrangements and affiliations
- Regularly appeal Medicare denials at the administrative law judge level for a durable medical equipment supplier
