Washington, District of Columbia, United States
I have worked on the provider side, as a Federal prosecutor and as defense counsel representing health care providers and suppliers around the country. Since leaving the DOJ, my practice has focused on compliance and regulatory matters. Our firm handles Medicare overpayment cases of all types (most of which involve extrapolated damages), internal audits / investigations, and other health law projects. I have represented a wide variety of health care providers in Medicare audits conducted by a variety of contractors. We defend health care providers in audits by UPICs, SMRCs and other CMS specialty program integrity contractors. Prior to serving in Washington, D.C., I worked as an Asst. U.S. Attorney in the Southern District of Texas, where I primarily handled False Claims Act cases. I was subsequently appointed as Chief of the Financial Litigation Unit. After the passage of HIPAA, I was detailed to Washington, DC to serve as the country's first National Health Care Fraud Coordinator. I was later promoted to Deputy Director, Legal Programs at the Executive Office for United States Attorneys. I have extensive experience presenting and lecturing at national conferences, seminars and webinars to prosecutors, investigators, auditors, provider groups and national associations, on a variety of health care regulatory issues. In addition to representing health care providers, I serve as Compliance Counsel for two national associations, the American Association of Clinical Endocrinologists (AACE) and the American Medical Billing Association (AMBA). I am also an Independent Review Organization (IRO) reporting to the Department of Health and Human Services, Office of Inspector General in connection with Corporate Integrity Agreements (CIAs). Finally, I am a "Certified Professional Coder" and a "Certified Medical Compliance Officer." Specialties: Health Law; Compliance; Medical Coding and Billing
My practice has consistently been focused on health care fraud defense and regulatory matters. Represent a wide variety of health care providers in both civil and administrative proceedings. Advise a variety of specialty health care providers in the areas of skilled therapy, pain management, home health, hospiice, oncology, durable medical equipment and ambulance services, in fraud, compliance and regulatory matters. Represent individual and corporate health care providers in ongoing litigation under the False Claims Act, addressing concerns raised by the Department of Justice. Work with health care providers to properly incorporate provisions into a client’s overall effective compliance strategy. Conduct internal investigations and audits in connection with possible False Claims Act, Federal Anti-Kickback Act, and other potential statutory and regulatory violations.
Represented individual and corporate health care clients in various complex civil and criminal proceedings. Successfully obtained complete declinations in connection with three separate qui tam suits. In other cases, obtained favorable settlement in connection with False Claims Act case brought against clients.
Prior to serving in Washington, DC, worked as an Assistant United States Attorney in the Southern District of Texas, Houston office, where primarily handled False Claims Act matters and cases. Subsequently appointed as Chief of the Financial Litigation Unit for the Southern District of Texas. Detailed in 1997 to the Executive Office for United States Attorneys in Washington, DC as its first National Health Care Fraud Coordinator. In this capacity, advised Assistant United States Attorneys around the country on civil and criminal health care fraud statutes, fraud schemes, investigative tools, medical records privacy concerns, and other health care fraud issues. Instrumental in implementing DOJ guidance on use of the False Claims Act in civil health care matters. Received numerous performance and achievement awards while with the Department of Justice. In 1999, received a Director’s Award (Executive Office for United States Attorney’s highest award) for work on health care fraud issues.