Healthcare Law

WMO has represented a variety of healthcare clients including hospitals, home health agencies, physicians and physician group practices, physician hospital organizations, physician practice management companies, consulting firms and cost containment companies. WMO counsels such clients in the areas of healthcare compliance, transactions, government investigations, litigation, and whistleblower/False Claims Act cases.

Founding partner Scott C. Withrow authored Managing Healthcare Compliance in 1999, and Managing HIPAA Compliance in 2001, both published by the American College of Healthcare Executives. WMO has published an innovative analysis of the interplay between federal anti-kickback and physician self-referral (Stark) laws.

Healthcare Law Compliance

At WMO, we have years of experience advising clients on healthcare law compliance. We represent physicians, physician groups, hospital organizations, pharmacists, and local and regional hospitals.

We have up-to-date knowledge regarding industry rules and regulations and provide our clients advice on compliance with HIPAA, self-referral (Stark) laws, federal Anti-Kickback laws, and other state and federal laws regulating providers and institutions.

WMO assists healthcare providers, suppliers, and organizations with their compliance needs. Compliance issues stemming from federal healthcare laws can be very detailed and complex. Our lawyers can assist with developing and updating billing policies to be in compliance with Stark and HIPAA. Scott C. Withrow, one of the firm’s founding partners, develops training programs and educational presentations with regard to billing, HIPAA security, and HIPAA privacy policies for hospitals and physician groups in order to educate physicians and staff on compliance issues. Our attorneys also review contracts and other financial relationships for Stark Law and Anti-Kickback law compliance and draft contracts that are compliant with federal healthcare laws and regulations.

Whistleblower/False Claims Act Cases

We represent whistleblowers in False Claims Act cases, which include Medicare fraud and healthcare fraud. We have been highly successful in litigating these cases.

The False Claims Act (FCA) covers fraudulent claims made against a federal agency, program, contract, or grant. The FCA permits whistleblowers, referred to as relators, to bring a case on behalf of the federal government to recover damages. These cases, known as qui tam lawsuits, allow the relator to sue the wrongdoer on behalf of the government.

In order to file a claim under the FCA, the relator must file a lawsuit and must be the first one to do so. The qui tam suit is filed “under seal,” meaning that it is kept a secret from the wrongdoer in order to give the government time to investigate the claims. Once the government investigates the claims, it will decide whether or not to intervene. Typically, relators are awarded a percentage of the recovery, ranging from 15% to 25%. In instances where the government does not intervene, the relator is entitled to a larger percentage of the recovery, ranging from 25% to 30%. If the government intervenes, the chances of success are much higher; however, the relator may still move forward with the case if the government does not intervene.

WMO investigates and litigates qui tam actions on behalf of whistleblowers in actions across the country, including in Georgia and Florida. Our services include investigating and filing qui tam claims, assisting prosecutors and the federal government in pursuing qui tam cases, litigating qui tam cases, and negotiating settlements.

Recent Representative Cases

  • U.S. ex rel. Baklid-Kunz v. Halifax Hospital Medical Center et al., Case No. 6:09-cv-1002 (M.D. Fla.) (Halifax compliance officer filed qui tam action alleging that hospital’s compensation of employed medical oncologists violated the Stark Law and resulted in Halifax Hospital settling with the Department of Justice for $85 million).