Health Care

In this era of heightened government enforcement, perhaps no industry is as closely regulated and scrutinized as healthcare.  Between changing Medicare rules and regulations, whistleblowers lawsuits under the False Claims Act and industry-wide investigations led by federal prosecutors, no company in the healthcare or pharmaceuticals industry is safe from risk.  Your involvement in a wide range of investigations, enforcement actions and audits potentially can lead to catastrophic criminal, civil and administrative penalties and incarceration for individual executives and employees. Utilizing our experience as former federal prosecutors with expertise in healthcare fraud, pharmaceuticals fraud and qui tam investigations, we regularly defend clients in criminal and civil matters in federal and state jurisdictions throughout the country.  We represent corporations of all sizes as well as individual executives and employees. We also are experienced in serving as “pool counsel” for the employees of corporations.  Frequently, we are asked to conduct internal investigations on behalf of corporations, boards of directors or audit committees regarding healthcare and pharmaceutical regulatory compliance. Our cases often involve allegations related to:

  • Offering or receiving kickbacks and other financial inducements;
  • Creating or maintaining improper financial relationships in violation of the Stark Act
  • Billing improprieties either for services not rendered, not medically indicated or necessary, upcoding and double billing;
  • Filing of false claims with government health programs;
  • Provision of inadequate or substandard medical care;
  • Provision of experimental or cutting-edge medical treatments not in line with relevant standards of medical care;
  • Improper sales and marketing of drugs, medical devices and durable medical equipment; and
  • Improper branding, labeling and dispensation of pharmaceuticals, devices and other products regulated by the Food, Drug, and Cosmetic Act.

Featured Capabilities

Marcus Neiman Rashbaum & Pineiro, LLP is one of the nation’s leading law firms in defending government investigations and criminal and civil actions relating to compound pharmaceutical sales. Our law firm has unmatched experience in defending the full spectrum of companies and individuals who may face allegations of improper compound pharmaceutical sales practices, including prescribing physicians, pharmacy owners, pharmacists, marketing companies, pharmacy sales representatives, and marketing consultants.

With decades of national health care litigation experience as former federal prosecutors and defense lawyers, we understand the intricacies of your business and the high stakes that you face from government enforcement actions. We’ve won trial acquittals in high-profile federal health care prosecutions and quietly resolved “bet the company” government investigations without adverse publicity for our satisfied clients. Often, we are entrusted to successfully navigate clients through complex, parallel health care proceedings in criminal and civil actions.

Our firm is well versed in the intricacies of whistleblower and false claims act investigations and litigation. We have the varied skill set required to devise comprehensive defense strategies across parallel civil and criminal enforcement actions which are a regular feature of qui tam defense work. We appreciate the serious collateral consequences that these matters can cause for our clients and craft approaches intended to minimize business disruption and reputational damage. We also litigate aggressively when necessary and have successfully dismissed unfounded qui tam lawsuits on behalf of thankful clients.

On occasion, as part of our plaintiff’s litigation practice, we will represent a small number of qui tam relators and whistleblowers in federal and state actions that we have thoroughly investigated pre-complaint to assess likely government interest. Contrary to popular belief, most whistleblower claims do not result in positive results for plaintiffs, with the government declining to join a majority of filed complaints. These cases to be successful take years of persistence and proactive lawyering. For these reasons, we take a thoughtful and measured evaluative approach to potential cases which we believe to be in our clients’ long-term interests. And for the cases we do file, we actively work with the government to maximize the chances of the government joining your case and of a successful outcome.

Our former government experience informs our firm’s approach in navigating clients through the many obstacles associated with healthcare enforcement actions, including Civil Investigative Demands or “CIDS”; program exclusion, revocation or suspension actions; professional licensing and disciplinary proceedings; program integrity audits, on-site inspections and reviews; prepayment reviews and overpayment disputes and appeals. We understand both your business and regulators’ priorities and employ that insight to achieve practical solutions for our clients that protect their core business concerns.

Recent MNR Cases

Health Care