Healthcare Fraud & Abuse

Today’s health care, pharmaceutical, life sciences and medical device companies face ever expanding state and federal regulations, and are often targeted in parallel civil, criminal and administrative proceedings at the federal and state level. Additional collateral proceedings such as product liability suits, third party payor suits and employment issues are frequent by-products of civil and criminal investigations. Morris, Manning & Martin’s deep expertise in the healthcare sector, along with its collaborative approach of teaming with appropriate substantive and regulatory experts, provides clients with full service, multi-disciplinary representation when confronted with such issues. In addition, the firm utilizes a broad array of mobile resources and technology to respond quickly and efficiently to pressing client needs.

A Diverse Team of Specialists

Attorneys in the Healthcare Fraud and Abuse Practice have extensive training and experience in the healthcare industry and with various federal healthcare compliance and regulatory matters. Two of the Healthcare Fraud and Abuse Practice’s members have served as in-house counsel at large Georgia hospitals, providing unique insight into the challenges faced by many of our clients. Additionally, one of our practice members is a former Assistant United States Attorney who served as the federal Criminal Healthcare Coordinator, in which capacity she oversaw all healthcare investigations and prosecutions in her office’s district, including investigations into and prosecutions of federal providers and pharmaceutical companies. These combined prior experiences provide a unique understanding of the investigative and prosecutorial process, as well as an appreciation for the consequences of the findings that may arise from such inquiries.

Should the need arise, we provide clients with a creative, hardworking litigation team equipped to deal efficiently, effectively and responsively with the most sensitive and challenging legal issues. Each case is engaged with our aggressive, hands-on approach and, always conscious of the cost of litigation, we strive to formulate a strategy to obtain the best possible result, carried out in a practical, cost-effective manner that best applies our resources to meet each client’s objectives.

Representative Matters:

  • Represented pharmaceutical company in complex internal investigation relating to government allegations of off label marketing, Anti Kickback violations and potential manipulation of the AWP.
  • Coordinated criminal investigation into pharmaceutical manufacturer and distributor for misbranding and cGMP violations.
  • Represented several clients in EMTALA investigations and appeals.
  • Represented owner of pharmacy in federal investigation and related Board of Pharmacy proceedings relating to internet pharmacy prescriptions.
  • Represented clients in federal investigation of Medicare billing compliance issues.
  • Represented clients in self-disclosure and negotiation of resolution for governmental payer program enforcement activities.
  • Represented clients in “Qui Tam” actions involving physician and hospital regulatory compliance issues.
  • Representing clients in regulatory audits and billing compliance reviews on state and federal levels.
  • Represented major pharmaceutical company in connection with investigation and resolution of investigation into certain prescribing practices.
  • Represented large physician practice in investigation of certain off-label prescriptions.
  • Assisted in representation of clinical laboratory testing company with respect to certain unbundling practices.
  • Assisted in representation of president of generic drug company in criminal and civil market allocation investigation.
  • Co-trial counsel for executive of managed care company who brought suit for violation of retaliatory discharge provisions of False Claims Act resulting in substantial jury verdict for executive.
  • Advise on compliance structuring of various arrangements for hospital systems, academic medical center and physician groups.

Practice Areas

Industry Focus