Fraud & Abuse

The federal and state health care fraud and abuse laws are both comprehensive and complex. Members of the Benesch Healthcare+ Practice Group are extremely conversant with the (1) federal anti-kickback statute, safe harbor regulations, case law, Office of Inspector General ("OIG") advisory opinions, "fraud alerts" and other issuances by the OIG and the Centers for Medicare and Medicaid Services ("CMS" (formerly the Health Care Financing Administration); (2) "Stark" (physician self-referral) statute, regulations, case law and advisory opinions; (3) federal statutes establishing criminal offenses and grounds for civil monetary penalties and exclusion under the federal Health Care Programs; (4) federal False Claims Act and case law (including matters relating to private "whistleblower" actions); and (5) OIG Voluntary Disclosure Protocol.