16 Pietragallo Lawyers Named in 2022 Pennsylvania Super Lawyers and Rising Stars

2022/05/23

Pietragallo is pleased to announce that 16 lawyers have been named as 2022 Super Lawyers and Rising Stars, including partner Marc Raspanti who was recognized in the Top 100 in Pennsylvania and Philadelphia. Super Lawyers is a service of Thomson Reuters legal division which compiles a list of outstanding lawyers from more than 74 practice areas. Each year, a research team at Super Lawyers conducts a multi-phase selection process reviewing independent research, peer nominations, and peer evaluations. With the objective being to provide a reliable, wide-ranging list of attorneys that can be used as a source for finding exceptional legal counsel. The following were chosen as Pennsylvania Super Lawyers: Gaetan J. Alfano Joseph J. Bosick Mark Gordon P. Brennan Hart Christopher A. Iacono Michael A. Morse William Pietragallo, II Francis E. Pipak, Jr. Marc S. Raspanti (Top 100 in Pennsylvania and Top 100 in Philadelphia) Douglas K. Rosenblum Clem C. Trischler Paul K. Vey The following were chosen as Pennsylvania Rising Stars: Ashley J. Kenny John W. Kettering Alexander Owens Peter St. Tienne Wolff   About Pietragallo Pietragallo Gordon Alfano Bosick & Raspanti, LLP is a multi-disciplined business and commercial litigation firm headquartered in Pittsburgh with six offices throughout Pennsylvania, Florida, Ohio, and West Virginia from which we are able to serve our clients in all 50 states and the District of Columbia. Read More

When Work-Life Balance is Underwater

2022/05/13

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Pietragallo Law Firm Contributes to $24.5 Million Recovery as Multi-State Pain and Surgery Practice and Key Executives Settle False Claims Act Suits

2022/04/12

TUESDAY, APRIL 12, 2022 – The United States Attorney’s Office for the Middle District of Florida and the Department of Justice announced today the settlement of four qui tam cases filed in Tampa. One of these whistleblower cases was filed by Dr. Sheldon Cho, a pain management physician and former employee of Florida Pain Relief Group, PLLC, and Dawn Baker, a national recruiter who had placed physicians with Physician Partners of America, LLC. Two individuals associated with these corporate defendants are also parties to the settlement.[1] Ms. Baker and Dr. Cho alleged in their Qui Tam Complaint that Physician Partners of America, LLC, a multi-state pain management and surgical provider, Florida Pain Relief Group, PLLC, Texas Pain Relief Group, PLLC, Physician Partners of America CRNA Holdings, LLC, Medical Tox Labs, LLC, Medical DNA Labs, LLC (“Physician Partners of America, LLC and its affiliated entities”), and two of the company’s executives, namely, founder, Rodolfo Gari, and the company’s Chief Medical Officer, Abraham Rivera (collectively “PPOA”), knowingly submitted or caused the submission of false claims to Government healthcare programs, including Medicare, Medicaid, the Federal Employees’ Health Benefits Program (FEHBP), and Tricare, for unnecessary quantitative urine drug testing (UDT), pharmacogenetic tests, and psychological tests while also systematically upcoding anesthesia services. The matter has been pending before the Honorable Mary S. Scriven of the United States District Court for the Middle District of Florida. The whistleblowers alleged in their Qui Tam Complaint that PPOA pressured their physicians and other healthcare providers to subject patients to quantitative urine drug tests, pharmacogenetic tests, and psychological tests regardless of medical need. Relators alleged PPOA violated the Stark Law by financially incentivizing their physicians to order quantitative UDT. Relators also asserted that PPOA systematically charged government payors for general anesthesia when lower-level anesthesia services were provided (i.e., upcoding). The United States did not file its own False Claims Act complaint but intervened in the four qui tam complaints. Read More

The Physician Payments Sunshine Act and the Future of Healthcare Transparency: Part 2

March 2, 2022

This is part 2 of a two-part article series. Part 1 was published in the February 2022 issue of Compliance Today and discussed the issues in the healthcare industry that led to the enactment of The Physician Payments Sunshine Act, it’s key statutory language, the potential penalties, and the Act’s evolution. The Physician Payments Sunshine Act (PPSA) took effect in 2013.[1] It requires medical product manufacturers to disclose to the Centers for Medicare & Medicaid Services (CMS) payments or transfers of value made to physicians or teaching hospitals. PPSA also requires manufacturers and group purchasing organizations to disclose any physician’s ownership or financial interest in those companies. The disclosed data is published annually in a publicly searchable database.[2] The rationale behind the public availability of the data is to empower patients through transparency to mitigate the putative effect of financial incentives on clinical behavior and the public and prevent physician-industry conflicts of interest. Part 1 of this article[3] offers a comprehensive analysis of the major healthcare regulatory enforcement statutes and their continuingly expansive use. First, it considers the issues in the healthcare industry that led to the enactment of the PPSA are relevant to an understanding of the current law and its growing enforcement. Next, it discusses PPSA key statutory language and its evolution and considers the impact from a fraud and abuse standpoint. Part 2 of this article reviews the significance of the first examples of Department of Justice enforcement of the act, as well as the likely increase of private PPSA enforcement. Other sunshine acts, including state and international acts, are also highlighted. Finally, an examination of the future of transparency statutes, including the Hospital Price Transparency regulation,[4] the newest major transparency statute proposed; the Prescription Drug Price Transparency Act; and the Transparency in Coverage statute, which support the notion that transparency is a trend in the healthcare industry that will withstand the test of time. Read More

The Physician Payments Sunshine Act and the Future of Healthcare Transparency: Part 1

2022/02/02

Part 2 of this article series will be published in the March 2022 issue of Compliance Today and focus on examples of enforcement actions and examine the future of transparency statutes. The Physician Payments Sunshine Act (PPSA) took effect in 2013.[1] It requires medical product manufacturers to disclose to the Centers for Medicare & Medicaid Services (CMS) payments or transfers of value made to physicians or teaching hospitals. The act also requires manufacturers and group purchasing organizations to disclose any physician’s ownership or financial interest in those companies. The disclosed data is published annually in a publicly searchable database.[2] The rationale behind the public availability of the data is to empower patients through transparency to mitigate the putative effect of financial incentives on clinical behavior and the public and prevent physician-industry conflicts of interest. This two-part article provides a comprehensive analysis of the major healthcare regulatory enforcement statutes and their continuingly expansive use. First, we’ll reference the issues in the healthcare industry that led to the enactment of the PPSA that are relevant to an understanding of the current law and its growing enforcement. Next, we’ll discuss key statutory language and PPSA’s evolution. Then, we’ll consider the impact from a fraud and abuse standpoint, which is important to appreciate the significance of the first examples of Department of Justice enforcement of the act that follow, as well as the likely increase of private PPSA enforcement. We’ll also highlight other sunshine acts, including state and international ones. Finally, we’ll examine the future of transparency statutes, including the Hospital Price Transparency regulation,[3] the newest major transparency statute proposed; the Prescription Drug Price Transparency Act; and the Transparency in Coverage statute, which support the notion that transparency is a trend in the healthcare industry that will withstand the test of time. The lead-up to the enactment of the Physician Sunshine Act After years of calls for the healthcare industry to shift toward a more transparent and consumer-friendly environment, the Patient Protection and Affordable Care Act (ACA) passed in 2010, including the PPSA codified at 42 U.S.C. Read More

Pamela Coyle Brecht to present at Federal Bar Association’s 2022 Qui Tam Conference

2022/02/24

On Thursday, February 24, 2022 Pietragallo partner Pamela Coyle Brecht will be presenting on “Private Equity – The Newest Face at the FCA Table” at the Federal Bar Association’s 2022 Qui Tam Conference. This annual event provides timely perspectives from all sides of the FCA ecosystem: prosecutors, relator-side attorneys, defense counsel, inspectors general, federal judges, and in-house counsel. For more information and to register, visit: https://www.fedbar.org/event/quitam22/ Read More

Pamela Coyle Brecht to present at Marcum Corporate Compliance & Fraud Summit

2021/10/07

On October 7th, Pietragallo partner Pamela Coyle Brecht will be a panelist at the Marcum Corporate Compliance & Fraud Summit. Pam, and her co-panelist David Glusman, Partner at Marcum LLP will be discussing Forensic Accounting in Healthcare. During our session, you’ll be introduced to anti-kickback and fraud and abuse issues in healthcare. Join us for this two-day virtual webinar and register here, https://lnkd.in/deYRtj3C Read More

Pamela Coyle Brecht to present at Pennsylvania Bar Institute’s A Day on Health Law 2021

2021/10/28

On Thursday, October 28, 2021, Pietragallo partner Pamela Coyle Brecht will present a “False Claims Act Update” at Pennsylvania Bar Institute’s A Day on Health Law webinar. A Day on Health Law is a one-day, six-hour spin-off of PBI’s annual Health Law Institute. The Health Law Institute brings health law professionals comprehensive updates, insights and practical advice and the opportunity to tailor your own personalized agenda through numerous breakout session options in addition to the complete sessions. To join Pam and an outstanding roster of healthcare professionals visit: https://lnkd.in/gfRu_EwJ Read More

Marc Raspanti speaking at American Bar Association’s False Claims and Qui Tam Trial Institute 2022

2022/04/25

Pietragallo partner Marc S. Raspanti will be speaking at the upcoming American Bar Association’s April 25-27, 2022 False Claims and Qui Tam Trial Institute. Marc will be participating in an AseraCare Update: Insights into Objective Falsity in Litigation and Trials Panel and a Legislative Update Panel. This event, taking place in Coral Gables (Miami), FL, will show how experienced trial counsel try a False Claims Act jury trial to verdict. Attendees get to be a part of the experience, observe the jury deliberations and gauge how jurors respond to the themes, evidence and arguments presented at trial. It’s all the benefits of a mock jury trial exercise at a fraction of the cost! For more information, or if you’d like to attend, please visit https://ambar.org/fct2022 to register. Read More

Pamela Coyle Brecht to present at Health Care Compliance Association’s 2022 Managed Care Compliance Conference

2022/01/31

On Monday, January 31, 2022, Pietragallo partner Pamela Coyle Brecht will be presenting on “The Dos and Don’ts of Medicare Advantage and Medicaid Managed Care: Lessons from Recent Enforcement Activity” at the HCCA’s Managed Care Compliance Conference. This is an annual event for individuals who manage compliance at health plan providers. Learn the latest practices, share strategies, and connect with peers and mentors who face similar challenges. For more information and to register, visit: https://lnkd.in/gyjX4U7X Read More