Defining Success

Early Communication Helps Defense of Whistleblower Claims

A large academic medical practice

Situation

A large academic medical practice received a series of Civil Investigative Demands and subpoenas from the U.S. Department of Justice, which alerted them that they were under investigation related to their billing to Medicare and Medicaid.

Challenge

The client needed assistance with responding to the inquiries from the DOJ, and to preemptively investigate its own billing and compliance programs and to begin formulating a defense to any potential fraud claims.

Approach

We pledged cooperation with the DOJ in its investigation and immediately opened a line of communication with government investigators and the Assistant U.S. Attorney assigned to the case. We coordinated all communication through counsel so as to insulate the client from government investigators. When the time was appropriate, the U.S. Attorney shared the particulars of its investigation. We discovered that the Government was investigating the merits of a whistleblower lawsuit brought under the False Claims Act. We developed a defense to the accusations and presented the defense to the U.S. Attorney.

Result

After presenting our defense position to the U.S. Attorney, we continued to assist the U.S. Attorney in making its decision regarding whether to intervene in the False Claims Act whistleblower lawsuit. After much communication, the U.S. Attorney declined to intervene in the lawsuit. The whistleblower then pursued the lawsuit. After the whistleblower served the client with a copy of the Complaint, we immediately moved to dismiss the Complaint due to deficiencies that we observed in the pleadings. After oral arguments, the Court dismissed the lawsuit.