Health Care

The attorneys of Pietragallo’s Health Care practice, many of whom are former federal or state prosecutors, are experienced in handling the numerous, diverse and ever-changing litigation needs of our health care clients, including:

  • Civil and administrative litigation brought by federal and state agencies involving allegations of fraud or other misconduct
  • Civil litigation brought by private insurance carriers, including health insurance carriers and automobile insurance carriers, involving allegations of fraud or other misconduct
  • Disciplinary investigations and hearings by hospitals and health systems, including “disruptive physician” allegations, credentialing and privilege issues and medical staff disputes
  • Medicare, Medicaid or private health care insurance carrier exclusion litigation
  • Investigations and disciplinary proceedings by all manner of professional licensing boards
  • National Practitioner Data Bank issues
  • Litigation involving the separation of a provider from a practice group or the dissolution of a practice
  • Litigation concerning leases, contracts, employment agreements, restrictive covenants, non-competes, business disputes arising from business acquisitions
  • Litigation involving antitrust issues
  • Litigation concerning intellectual property in the healthcare industry, including medical equipment patents, copyright and trademark
  • Investigations by federal and state regulatory agencies, including the Food and Drug Administration, Drug Enforcement Agency, Health and Human Services, Medicare and state Medicaid agencies
  • Overpayment demands by private health insurance carriers, Medicare and state Medicaid agencies
  • Medical malpractice defense

Our clients come from all areas of the health care industry. We have represented hospitals, health care practice groups of all sizes, clinics, physicians and surgeons, nurses, nurse practitioners, physician’s assistants, dentists, anesthesiologists, chiropractors, health care entrepreneurs, pharmaceutical executives, medical device manufacturers, medical billing companies, health care insurers, diagnostic laboratories, medical schools and all types of sales and marketing representatives.

Our attorneys regularly guide clients through the complex, and often conflicting, web of laws, regulations, policies, billing codes and compliance issues that often serve as the basis of health care litigation. As a result, we regularly provide compliance advice to clients in all areas of the health care industry, and help clients formulate compliance plans, establish compliance hotlines and provide compliance training.

Our attorneys work in close association with members of our other practice areas to provide our health care industry clients with a full range of services in related areas of the law, including: employment litigation; government investigations on white collar defense; compliance and contractual issues; business transactions; intellectual property rights and litigation; and insurance coverage and risk management.

Health Care Fraud Litigation

Federal and State authorities increasingly are using civil and administrative statutes and regulations, in conjunction with parallel criminal investigations, to investigate and pursue suspected health care fraud. Federal authorities do so through the federal False Claims Act, the Anti-Kickback Statute, and the Stark statute and its accompanying regulations. State authorities use civil remedies embodied in state False Claims statutes and state insurance fraud statutes.

In addition, private insurance carriers are aggressively using state insurance fraud statutes, many of which allow successful carriers to recover treble damages and attorney fees, to pursue health care providers they suspect of fraudulent billing practices. Civil judgments and/or administrative sanctions in these cases may result in severe collateral consequences, including debarment, exclusion and suspension from government health care programs and revocation of medical, health care or professional licenses.

Our attorneys, many of whom are former federal or state prosecutors and members of our White Collar Criminal Defense practice group, have defended countless health care providers, executives and businesses. They are nationally recognized as leaders in the defense of civil and criminal health care fraud cases. This experience is paramount in aggressively litigating the complex issues involved in defending civil fraud and misconduct claims, while still protecting the clients’ rights in any existing or potential parallel criminal proceedings.



Kevin E. Raphael —

Michael A. Morse —

News & Events

SEC Heightens Compliance Enforcement of Public Companies in 2022
September 2, 2022
With the appointment of Gurbir Grewal as enforcement director of the Securities and Exchange Commission (SEC), 2022 has, as expected, seen more stringent oversight into public companies. Read More
23 Pietragallo Lawyers Named in 2023 The Best Lawyers in America and Ones to Watch
August 18, 2022
Pietragallo Gordon Alfano Bosick & Raspanti, LLP is pleased to announce that 23 lawyers have been named as 2023 The Best Lawyers in America and 2023 Ones to Watch, including Tama Beth Kudman who was recognized as 2023 Lawyer of the Year in West Palm Beach for Criminal Defense: White-Collar. Read More
Health Law Handbook (2022 Edition) Pre-Publication
July 15, 2022
Kevin E. Raphael, Christin M. Roberts, and Daniel P. Wotherspoon have authored the chapter “The Reverse False Claims Act: A Relatively Unknown, But Increasingly Used, Provision of the FCA” in the 2022 Health Law Handbook that will be released on October 26, 2022. Read More
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