Health Care Litigation – Civil & Criminal

A significant percentage of Miedel & Mysliwiec LLP's clients are doctors or other health care providers. Our representations for a client can involve defending providers against insurance companies, regulatory agencies like HHS, and law enforcement civil and criminal investigations. We also coordinate representation for health care professionals facing state licensing issues. Sometimes our representations involve all of these issues. They can also involve representation in New York State, the Southern or Eastern Districts of New York, or in proceedings before the Department of Health and Human Services.

We have responded to "clawback" claims from insurance companies arguing that health care providers were overpaid. We have advocated at the Department of Health and Human Services to prevent a doctor from being excluded as a provider in federal health care programs. We have conducted internal investigations for clients to determine potential liability and respond to audits, subpoenas, or other legal proceedings. We have defending against "whistleblower" or government-initiated Civil False Claims Act health care fraud claims. And, we have successfully defended against criminal investigations and/or charges alleging that clients committed health care fraud.

Representative Matters

Our recent health care representations include:

  • Advocating for several small health care organizations and doctors to refute "clawback" claims from managed care organizations. These claims have ranged anywhere from $50,000 to almost $2,000,000 in value;
  • Persuading the Office of Counsel to the Inspector General for HHS not to exclude a doctor allegedly responsible for health care fraud;
  • Negotiating settlements with the Department of Justice for the resolution of alleged multimillion dollar Civil False Claims Act violations;
  • Persuading the Department of Justice not to seek criminal charges against a doctor accused of over $500,000 in health care fraud; and,
  • After a doctor had already been arrested and charged with a health care fraud in excess of $10 million, convincing the Department of Justice to agree to an eventual dismissal of the charges provided that the doctor instituted a compliance program and had no further violations.