Our health care litigation team has substantial experience advising and defending payers and providers across the spectrum of litigation issues that affect health care businesses. This includes reimbursement disputes, civil and criminal fraud investigations, contract claims, governmental contracting challenges, non-compete disputes, antitrust issues and subpoena responses. We handle all aspects of these claims, from government investigations and pre-litigation disputes through trial and appeal. We help clients navigate government administrative proceedings and resolve disputes through arbitration, mediation and settlement.
Our clients are managed care organizations, hospitals and health systems, specialty clinics, health care networks, federally qualified health centers, diagnostic facilities, ambulatory surgery centers, academic medical centers and physician groups.
- Fraud & Abuse Advice and Defense
- Government and Commercial Reimbursement Disputes
- Enforcement Actions
- Government Administrative Proceedings
- Payer-Provider and Other Health Care Disputes
- Class Action Defense
- Employment Litigation and Arbitration
- Tax Controversy
Fraud & Abuse Advice and Defense
Our core health care litigation team includes former trial attorneys for the U.S. Attorney’s offices in southern California, Washington and the District of Columbia; a former trial counsel for the U.S. Department of Justice; and a former Oregon Department of Justice Senior Assistant Attorney General. When combined with our broader government investigations team, we have considerable background on both the prosecution and defense sides of government investigations. We bring this experience to bear when helping health care businesses prepare for and defend against civil and criminal investigations and prosecutions. We have broad experience defending investigations and claims related to the Stark Law, Anti-Kickback Statute, False Claims Act and similar state laws that carry the risks of civil and criminal penalties and serious business disruption.
Payer-Provider and Other Health Care Disputes
When representing providers in payment disputes, the complex framework of health care payment systems creates dual challenges: the need to advocate for providers pursuing reimbursement for their services and to defend them against claims of inappropriate billing or over-charging. We offer a sophisticated team familiar with Medicaid and Medicare rules, government investigations, managed care contracting and payment, and class action defense to help providers navigate this balance and present a strong defense. We also represent managed care plans in negotiating and defending payment disputes with providers. Our experience representing both payers and providers gives us a unique perspective that allows us to both resolve cases quickly and present a strong defense. Additionally, we represent health care industry participants in traditional commercial disputes involving fiduciary duties, breach of contract claims and business torts.
Labor Relations, Employment Litigation and Arbitration
We have extensive experience representing hospitals, clinics, long-term care providers, physician groups and health care companies in employment litigation and traditional labor relations—both those common to any employer and those unique to the health care industry. We understand how the mission and work functions of a health care facility have an impact on wage and hour issues, discrimination claims, relationships with independent contractors, executive agreements and non-compete protections. In particular, we understand how common employment disputes have the potential to develop into a whistleblower claim and how best to manage this risk. We appreciate the need to maintain the highest quality patient care with minimal disruption or inefficiency that can arise during employment disputes.
Our first goal is to help health care entities avoid tax controversies, but when a dispute arises our tax litigators are standing by with the negotiation and litigation skills needed to resolve the matter as favorably as possible. We have extensive experience advising both taxable and tax-exempt health care organizations on complex audits, administrative appeals and proceedings in federal and state courts. Representative issues include all variety of federal and state income tax disputes, classification of health care workers as employees for federal tax purposes, state property tax exemption for nonprofit providers, and application of real estate transfer taxes to nonprofits.