INVESTIGATIONS, AUDITS AND COMPLIANCE

INVESTIGATIONS, AUDITS AND COMPLIANCE

GW was one of the first law firms to recognize the importance of creating a Investigations, Audits and Compliance Practice Group. This practice group focuses on the unique regulatory and business concerns of the health care industry. We advise our clients on compliance-related matters, including the formulation of client-specific compliance programs. The Investigations, Audits and Compliance Practice Group represents hospitals, nursing homes, certified and licensed home health agencies, physician practices, clinical laboratories, billing companies and others. We represent clients in connection with Federal (Office of the Inspector General), State (Attorney General and the Department of Health), criminal, civil and administrative investigations, audits and prosecutions. Many of our attorneys in this Practice Group are former government prosecutors or criminal defense attorneys.

The Investigations, Audits and Compliance Practice Group advises our clients in the following representative areas:

  • The development, implementation and supervision of corporate compliance programs in accordance with the Federal Sentencing Guidelines and the model programs published by the Office of the Inspector General (OIG) of the US Department of Health and Human Services
  • Conflict of interest
  • Legal audits of affiliation, managed care and all other agreements, including "Stark," Fraud and Abuse, private inurement and antitrust issues
  • CPT and chargemaster analysis
  • Medicare and Medicaid billing, False Claims and Civil Monetary Penalties
  • Procurement, sole source and bidding
  • Compliance training
  • "White collar" defense under Federal and State law, including audits, investigations and other "health care fraud" matters