Healthcare Enforcement Defense

Prosecutors and regulators at the federal and state level have found fertile ground in uncovering and investigating violations of the healthcare laws and regulations, extracting high-dollar settlements from companies and sometimes handing out prison terms for individuals. The White Collar Defense and Investigations group is ready to help both companies and individuals in the healthcare field navigate the risks and, when necessary, defend them in criminal and regulatory inquiries.

With the implementation of and changes to the Affordable Care Act (ACA) and other changes to Medicare and Medicaid, the landscape continues to shift. Both state and federal law-enforcement authorities and regulators have stepped up enforcement of the healthcare rules. In addition, the substantial uptick in the number and size of data breaches has made compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) more important than ever.

Lawyers in the White Collar Defense and Investigations group have defended individuals and entities accused of violating the healthcare laws and regulations, investigated alleged violations of the rules and performed compliance audits in the healthcare industry. They have also defended investigations arising under the False Claims Act. Some of our additional experience has included:

• Defended company against allegations by state Attorney General of HIPAA violations for failing to encrypt protected health information
• Represented individual healthcare professionals facing criminal investigations and prosecutions
• Represented individual healthcare professionals in license-revocation actions
• Performed HIPAA audits to ensure compliance with data privacy rules
• Served as court-appointed monitor of Medicare and Medicaid health-insurance company under the terms of a deferred-prosecution agreement with the U.S. Department of Justice

In addressing these kinds of matters, the White Collar Defense and Investigations team works closely with lawyers in Day Pitney’s Healthcare Practice Group, including former in-house counsel, to coordinate a comprehensive response to client needs.