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Government Investigations, White Collar & Compliance

Health Care Fraud

  • Overview
  • Representative Experience

In recent years, the Department of Justice and the Office of the Inspector General for the Secretary of the Department of Health and Human Services have significantly increased their criminal and regulatory enforcement in the health care arena.

Now more than ever, health care providers, durable medical equipment suppliers, and other health care entities must be vigilant in ensuring compliance with federal health care program guidelines.

Fraudulent conduct can frequently lead to exclusion from federal health care programs and the specter of significant civil monetary penalties. Godfrey & Kahn has the substantive experience to assist companies in guarding against health care fraud through the implementation of proactive compliance programs, as well as many former federal prosecutors to advocate on behalf of those companies already involved in criminal or regulatory proceedings. In addition, the breadth of trial experience of our white collar practitioners ensures zealous and effective representation in qui tam actions and other litigation that may arise under the Anti-Kickback Statute, the Stark (self-referral) laws or similar legislation.

Representative Experience

Defended health care provider in parallel federal criminal and civil cases charging Medicare fraud and violations of False Claims Act

Investigated alleged illegal reselling of prescription drugs by health care company

Assisted physician practice group in investigation related to narcotics prescription practices of one of its members

Conducted internal investigation for nursing home that uncovered payment of illicit bonuses and embezzlement by senior executives

Convinced state prosecutor not to pursue criminal charges regarding alleged fraudulent billing practices

Represented physician in federal and state criminal investigations of alleged billing and prescription fraud


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