Healthcare

Representative Matters

• Represented a medical supply distributor and affiliated entities in a federal False Claims Act qui tam action alleging Medicare fraud, securing dismissal prior to the pleading stage through documentary evidence and sworn submissions, while claims against other defendants continued.
• Representing a New Jersey healthcare system and its leadership in litigation arising from termination of a surgeon’s staff privileges, defending claims for alleged wrongful suspension and lost income.
• Represented a real estate company as healthcare and regulatory counsel in developing assisted living facilities in Scotch Plains, East Brunswick, and Old Tappan in transactions exceeding $10 million.
• Advising a New Jersey-based ABA therapy organization in responding to a New Jersey MFD audit. This matter includes counseling the client on the MFD interview process, assisting in providing relevant documentation responsive to the audit, and advising the client on compliance with follow-up requests from the MFD in anticipation of an eventual resolution of the audit, including any repayment demands.
• Representing a healthcare system in drafting and negotiating a uniform exclusive radiology services agreement implemented across multiple hospitals, standardizing contractual terms and negotiating arrangements with regional radiology groups.
• Advised a medical practice in a Chapter 11 bankruptcy proceeding involving competing claims from a private equity sponsor, an acquisition lender, and the practice’s physician owners. The matter addressed disputes arising from the dissolution of the practice, restrictive covenant issues, and claims exceeding $35 million. The firm guided the parties to a global settlement and confirmation of a Chapter 11 plan of liquidation, resolving all claims.
• Successfully defended a company operating a post-acute network of skilled nursing and assisted living facilities in federal court, securing an order to dismiss a complaint alleging $10 million in damages for a range of due process and emotional distress claims.
• Successfully defended a client in an arbitration hearing against allegations of legal malpractice, resulting in all claims being dismissed and no award being issued.  
• Represented a physician charged with conspiracy to commit healthcare fraud involving fraudulent billing for medically unnecessary compound medications submitted to New Jersey state and local health benefits programs and private insurers.  
• Advised a healthcare company and its principals on regulatory and criminal compliance issues, including Anti-Kickback Statute considerations, in connection with the launch of a competing healthcare business following the departure of an executive from a prior employer.  
• Representing a physician in an ongoing investigation by the U.S. Attorney’s Office for the Eastern District of New York concerning alleged Medicaid fraud related to billing for non-medically necessary testing.  
• Assisted a New Jersey teaching hospital and biomedical research facility in securing local and county approvals for expansion of its Critical Decision Unit facility.  
• Represented a coalition of New Jersey hospitals in a $300 million constitutional challenge to the State of New Jersey’s charity care and Medicaid reimbursement regime, defending the hospitals’ takings claims through summary judgment, Appellate Division review, and New Jersey Supreme Court proceedings, resulting in published decisions affirming dismissal of the claims. The hospitals filed a petition for certiorari with the Supreme Court of the United States, which was denied.
• Represented a leading senior care provider in dozens of guardianship proceedings for residents lacking family decision-makers, coordinating with the New Jersey Office of the Public Guardian to secure medical authority and Medicaid eligibility.
• Representing two New Jersey health systems in high-stakes litigation against multiple Medicare Advantage plans seeking recovery of approximately $5 million in underpaid 340B drug reimbursements, following a U.S. Supreme Court decision invalidating the Center for Medicare and Medicaid Services’ reimbursement reductions; matters are proceeding toward mediation and arbitration.
• Represented a medical device company in its $50+ million sale to a Johnson & Johnson subsidiary, managing regulatory, diligence, and closing considerations.
• Represented an endoscopy practice in its $7.5 million acquisition by a major hospital system, addressing healthcare regulatory and transactional issues.
• Represented a private investment fund in a CPA firm’s acquisition of a medical coding company, navigating complex cross-border regulatory requirements involving India-based ownership.  
• Advised a private equity client in the acquisition and subsequent exit from an urgent care practice, successfully extracting the client near its original investment with full indemnification after operational failures.  
• Advised a medical electronic billing company in its $22 million sale (plus earn-out) to a national healthcare services provider.  
• Advised a medical electronic billing company in its $22 million sale (plus earn-out) to a national healthcare services provider.  
• Representing an emergency medicine physician practice in a dispute exceeding $11 million against UnitedHealthcare and affiliated entities arising from post-breach recoupment efforts following the Change Healthcare cyber incident, advising on recovery of lost revenue and structuring a resolution to preserve the practice’s financial viability.
• Obtained a seven-figure jury verdict in a wrongful death action, securing substantial economic and non-economic damages for the decedent’s surviving children after prolonged life support and failure-to-assist claims.
• Representing targets and key witnesses in federal and state healthcare fraud and Medicaid fraud investigations, including matters involving potential exposure exceeding $14 million, restitution risk, and incarceration, before New Jersey and New York authorities and the U.S. Attorney’s Office for the Eastern District of New York.
• Representing a clinical director subpoenaed by the New Jersey State Commission of Investigation in a wide-ranging inquiry into addiction treatment facilities involving alleged improper referrals, ownership structures, and quality-of-care concerns, with potential industry-wide reimbursement implications in the hundreds of millions of dollars.
• Advising a local government agency on the formation of a compliant “friendly P.C.” structure for the operation of New Jersey’s largest psychiatric hospital, including drafting and negotiating all transactional and governance documents under New Jersey healthcare law.
• Represented a global pharmaceutical company in successfully petitioning the New Jersey Supreme Court for special in-house licensure, enabling out-of-state counsel to practice in New Jersey on a permanent basis.
• Representing a physician practice owner in a seven-figure action for diversion of assets against a practice management company, seeking recovery of misappropriated funds and restoration of operational control.
• Represented an unlicensed owner of a licensed clinical social worker practice in a state fraud and abuse investigation with potential seven-figure reimbursement exposure and possible criminal referral.  
• Representing a major healthcare system in litigation brought by a former physician alleging wrongful termination of privileges and antitrust and Lanham Act violations, resolving the matter through a favorable settlement.
• Represented a New Jersey healthcare system in defense of antitrust and tort claims brought by a pediatric surgeon following revocation of privileges, securing a negotiated resolution.  
• Represented a New Jersey healthcare system in defense of fraud, breach of contract, age discrimination, and CEPA retaliation claims brought by three physicians and their surgical group seeking more than $9 million.
• Represented a New Jersey healthcare system and its Chair of Surgery in litigation brought by a trauma surgeon challenging a summary suspension of medical staff privileges. Following reinstatement through internal proceedings, the firm continued to defend the client in this $2.4 million action, which settled before trial. 
• Representing 170 hospitals nationwide before the Medicare PRRB in challenges to CMS’ historical calculation of IPPS rates dating to federal fiscal year 1986. The matter, valued in the hundreds of millions of dollars, seeks correction of longstanding reimbursement underpayments and remains pending before the PRRB.
• Representing over 300 hospitals nationwide in Medicare PRRB and federal court litigation challenging CMS’ application of the rural floor budget neutrality factor affecting federal fiscal year 2024 wage indices. The firm’s team secured expedited judicial review and filed suit in the U.S. District Court for the District of Columbia seeking declaratory relief and damages.
• Defending a major New Jersey health system against physician privilege-termination claims, including allegations of discrimination and improper peer review, where reinstatement would raise patient safety concerns; discovery completed and summary judgment pending.
• Served as lead counsel to a leading healthcare system in a high-profile legislative and appellate initiative to renew New Jersey’s involuntary commitment law, coordinating testimony before multiple legislative committees, negotiations with state agencies, and appellate advocacy, culminating in passage and gubernatorial signing of legislation with statewide impact on hospital emergency care and public safety.
• Serving as outside regulatory counsel to a multispecialty provider of healthcare services, leading internal investigations and compliance reviews in response to federal scrutiny of physician billing practices, including platelet-rich plasma therapy and “incident-to” billing, and guiding corrective action to mitigate fraud-and-abuse exposure and protect Medicare participation.
• Representing a pharmacy in restoring Medicare certification, resolving conditions-of-participation violations and securing Center for Medicare and Medicaid Services approval for re-enrollment, allowing the business to resume serving Medicare beneficiaries.  
• Guiding an outpatient psychiatry practice through Medicare and Medicaid compliance remediation, addressing opted-out Medicare billing issues and regulatory inquiries to preserve continued operations and avoid enforcement action.
• Represented a global medical equipment manufacturer in environmental permitting, ISRA compliance, and international corporate reorganizations, including resolution of Clean Water Act disputes resulting in $20–$50 million in avoided compliance costs.
• Representing the largest healthcare system in New Jersey in drafting and negotiating design and construction agreements for capital projects across its hospital network, including interior renovations, specialty medical upgrades, equipment relocations, and large-scale parking garage construction.

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