Fraud and Abuse & Corporate Compliance
Over the past 20 years, the prevention of health care program fraud, waste and abuse has become a top law enforcement priority. By virtue of extensive government and private sector experience, Sonnenschein is uniquely qualified to help clients minimize the fraud and abuse risks posed by their business arrangements and relationships and successfully address and resolve government (and whistleblower) audits, investigations, subpoenas and administrative, civil and criminal litigation.
Our large, talented and experienced team of fraud and abuse experts furnish services to health care organizations in four principal areas:
- First, firm attorneys assist our clients in ensuring that their various business arrangements, contracts, marketing initiatives and investment strategies comply with federal and state anti-kickback, physician self-referral, reassignment, fee-splitting, beneficiary inducement, gainsharing and related laws and regulations.
- Second, on behalf of providers, suppliers and other health care organizations, Sonnenschein attorneys conduct internal investigations, audits and risk assessments of coverage, billing, coding, reimbursement and documentation practices and procedures.
- Third, our attorneys defend health care organizations in connection with administrative, civil and criminal audits, investigations and litigation, including actions alleging improper coding, billing, pricing and reimbursement, as well as actions involving alleged violations of federal and state anti-kickback, physician self-referral and related laws and regulations.
- Fourth, drawing on our expertise in the above areas, Health Care Group attorneys develop tailored corporate compliance programs for health care organizations and help implement these programs by providing training and education to compliance officers, in-house counsel, management and billing, coding, reimbursement, marketing and clinical personnel.
