Health Care Audits and Investigations
The legal and business issues arising in the health care, biotechnology, medical device and pharmaceutical industries are unique. As highly regulated industries, these companies face complex challenges with respect to their business operations. Faced with an ever-changing array of regulations and pressures that must be balanced with ongoing business challenges and opportunities, such companies need legal representation from attorneys who have the broad-based background and experience necessary to help them meet these challenges.
Our client base is broad in scope, as we have represented numerous for-profit and nonprofit hospitals and health systems, ambulatory surgery centers, physician groups, academic medical institutions, managed care companies, health care technology companies, continuing care retirement communities, biotechnology, medical device, pharmaceutical companies, and providers of debt and equity capital in the health care space in regulatory, transactional and litigation matters.
Seyfarth’s health industry attorneys have deep experience with the federal fraud and abuse laws, including the federal Anti-Kickback Statute, Stark Law and False Claims Act. That knowledge extends to state fraud and abuse laws, including fee splitting and corporate practice of medicine.
We utilize that experience to counsel providers, and companies that do business with providers, on:
- Conducting internal investigations
- Defending RAC audits, ZPIC audits and Medicare, OIG and other governmental agency investigations and subpoenas
- Analyzing self-disclosure issues and guiding the client through the self-disclosure process
- Responding to actual or potential whistleblower issues
- Developing and implementing meaningful compliance plans
Our health lawyers serve as adjunct professors at law schools, and we regularly present and publish on fraud and abuse issues to the health care industry and the legal profession. We are very active in the American Health Lawyers Association, as well as state health law organizations where we practice.
The approach we take to fraud and abuse compliance is straightforward and practical. With regard to governmental investigations, we recognize that in many cases, you can win the battle but lose the war, and that in every case the lawyer has to be mindful of the legal fees. We also understand the high stakes involved with an external investigation, and we are tenacious in helping our clients achieve an optimal outcome.