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Successfully represented a physician group in an investigation by Department of
Justice of qui tam complaint alleging Medicare False claims; government declined
to intervene and plaintiff dropped all false claims allegations
Successfully represented long term care chain provider investigation by Department
of Justice alleging failure to properly report related party costs as basis for false
claims; provider was not required to enter either a CIA or CCA
Successfully represented skilled nursing facility in investigation by Department of
Justice alleging inadequate nurse staffing as basis for false claims; government
concluded investigation with no charges and no CIA requirement
Developed original methodology for demonstrating adequate nurse staffing in SNFs
to defend against government allegations of false claims and/or substandard
quality of care, as well as private malpractice or negligence causes of action
Successfully represented group of long term care providers in challenge to Medicaid
reimbursement rates in Idaho; state settled all claims for 100 cents on the dollar
Successfully represented skilled nursing facility in appeal at the PRRB of Medicare’s
denial of its request for a new provider exemption to the routine cost limits;
Medicare settled the claim for 100 cents on the dollar
Coordinated defense of government audits of large chain nursing home provider
(over 550 facilities) on issue of nursing hours allocation, including training facility
personnel on documents necessary to defend cost report allocations, and interface
with government auditors
Conducted on-site billing compliance audit of national prosthetics and orthotics
company as part of due diligence for private equity investor
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