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Health Care Fraud

Philadelphia Health Care Fraud Attorneys

Allegations of health care fraud can threaten the reputation and ongoing viability of health care providers, nursing homes, doctors and pharmaceutical companies. Any individual or organization that receives payments from the government (Medicare or Medicaid payments, for example) is at risk of health care fraud accusations related to coding, billing or other transactions.

Health Care Litigation Defense

Contact the law offices of Vaira & Riley, P.C. to schedule a consultation regarding allegations of health care fraud related to matters such as the following:

  • "Upcoding" of services rendered in order to collect higher Medicare or Medicaid payments
  • Inflated pricing of prescription drugs
  • Overcharging or underperformance with regard to medical services by physicians, long-term care facilities or pharmacists expecting to be reimbursed by state health assistance programs
  • Unauthorized charges for off-label uses of prescription medications

Read more about representative health care cases we have handled.

Early Intervention is the Key

By bringing defense attorneys on board early in a case, a client can increase the prospects for favorable resolution of a health care fraud case. A client such as a physician can carry on his medical practice with much greater peace of mind when defense lawyers comply with subpoenas and handle negotiations with government agencies such as Medicare or state health care assistance programs. The attorneys of Vaira & Riley, P.C. counsel clients and work to protect their legal rights throughout an investigation and after charges are filed.

Positioning Clients for Favorable Outcomes

Vaira & Riley, P.C. is often brought in as defense counsel after allegations have escalated to the point that a health care provider's back is against the wall. Attorneys of the law firm know how to negotiate with government agencies and position clients for such successful outcomes as:

  • Ceasing the investigation
  • Reduction in charges
  • Dropped charges
  • Reduction in penalties

Vaira & Riley, P.C. Counseled Whistleblower Clients Involved in Litigation Against Health Care Giants Tenet Healthcare and St. Barnabas Corp.

Our attorneys played a key role by providing counsel to parties who came forward to file qui tam complaints against two major health care providers who were accused of collecting excessive outlier payments from the Medicare system. In 2006, The Wall Street Journal reported that Tenet Healthcare Corp., had resolved a long and drawn out investigation and legal challenge from the U.S. Justice Department by agreeing to pay $725 million over three years "to settle allegations that it gamed the Medicare program to trigger extraordinarily large payments to the company in 2000 and 2002." Vaira & Riley was also involved in the litigation against New Jersey health care provider St. Barnabas Corp., which resulted in a settlement for $265,000,000.

Contact the law offices of Vaira & Riley, P.C. to schedule a consultation regarding medical insurance fraud allegations or any health care fraud investigation or charges.