Pepe & Hazard's Health Care Fraud and Abuse Practice Group plays a unique role in representing the interests of the insurance industry in combating fraud and abuse. We represent the insurance industry in fraud cases. We have wide experience in both the litigation process and alternative dispute procedures. The group's approach is straightforward, proven and unrestrained by geographical boundaries; routinely serving the largest health care payors throughout the entire nation. The group represents healthcare payors and property/casualty insurers in fraud recovery cases against individuals, laboratories, mail-order pharmacies, national medical providers, hospitals, medical clinics, durable medical equipment, manufacturers and distributors and other health care providers committing fraud.
Pepe & Hazard also represents whistle blowers on qui tam/False Claim Act ("FCA") lawsuits. On behalf of whistle blowers, we bring Medicare/Medicaid/TRICARE and Federal Employees Health Plan FCA cases under federal and state false claim laws. The group also works closely with prosecutors around the country, pursuing civil recoveries, seeking restitution and criminal penalties for providers who fraudulently bill our clients.
We seek clients, not cases. The practice group is distinguished by our progressive approach to understanding our clients' business and legal challenges. Moreover, our continuing, pro-active focus on obtaining favorable solutions, so as to meet our clients' business objectives has earned the practice long standing relationships with its clients and the respect of its peers.
The group's attorneys apply decades of practical experience, hard-nosed lawyering and teamwork. The defining elements of the group are its history, covering over three decades of success in and out of the courtroom, its ability to design creative legal strategies, to obtain early and decisive victories and favorable settlements and its close working relationship and understanding of our clients business.
We pioneered the use in multi-payor cases of technologically contemporary automated pay claims data assembly and the application of state-of-the-art analytics. This automated approach is a unique approach and a core tool in the group's liability and damage analysis. The group, in conjunction with its analytics of multiple clients' paid claims data, continues to monitor and improve on the safeguards that address the significant concerns regarding privacy and confidentiality of individual health information.
The practice group has an extensive investigative capability. Most of the group's cases in recent years have involved sophisticated investigations conducted outside the formal civil discovery process. The group brings together a rare combination of top-flight attorneys and professionals with experience representing healthcare payors and property/casualty insurers as both plaintiffs and defendants. We provide our clients with a blend of government, federal and state prosecutors, law enforcement, private practice and insurance and healthcare industry experience, and experience that serves our clients well in this complex area of the law.
Our Health Care Fraud and Abuse practice is widely recognized as being prepared to litigate when an appropriate settlement can not be reached. To date, the members of the practice have recovered more than $125 Million for more than two dozen private payors/insurance carriers, Medicare and the Federal Employees Health Plan programs.
When necessary, the group has assisted clients with internal investigations into allegations of fraud or wrongdoing and has helped them successfully navigate the intricacies of a government investigation. The group's approach is always to identify the potential collateral consequences caused by allegations of misconduct and to seek "global peace."
The overriding mission of the group is to provide its clients with sophisticated, responsive and cost effective legal services. We staff each case to the needs of that matter and work to provide skillful representation without duplication of attorney time. The group continually endeavors to expand its resources and areas of expertise to meet the changing landscape and needs of our clients in the increasingly complex healthcare industry.
Our attorneys have represented healthcare payor entities and property/ casualty issues in a wide variety of fraud matters. Overall, Pepe & Hazard has extensive and varied experience in investigating and litigating fraud cases across the country. |
