Health Care Government Investigations, Audits, and Self-Disclosures

Health care entities face unique risks and challenges due to the ever-increasing government regulation and enforcement of state and federal fraud and abuse laws. Robinson+Cole's Health Care Government Investigations, Audits, and Self-Disclosures Group integrates its in-depth substantive health care knowledge with its experience in conducting internal investigations and representing clients before state and federal authorities.

Our recent experience includes representing clients in connection with investigations by state lawyers general and other state agencies as well as the United States Department of Justice, the Department of Health and Human Services' Office of Inspector General, and the Centers for Medicare and Medicaid Services. These investigations related to alleged violations of state and federal antikickback laws, Stark laws, and the False Claims Acts. Our team has assisted hospitals, health systems, and other health care providers with engaging in internal compliance investigations, developing compliance programs, conducting compliance education and training, and implementing reporting protocols.

    • Experience
      • Regular advice to and representation of clients in proceedings before the Connecticut Department of Social Services regarding financial audits, administrative sanctions and Title XIX appeals.
      • Representation of one of Connecticut’s largest providers of home health services in connection with a multi-agency federal and state investigation into the company’s billing practices. Worked closely with the client to conduct an internal investigation of the agency’s billing processes to identify potential areas of exposure and to develop a comprehensive corporate compliance program. Successfully persuaded the United States Attorney’s Office not to pursue charges and to issue a formal declination letter.
      • Representation of a hospital network and behavioral health center in an investigation of billing practices brought by the Federal Bureau of Investigation and the Office of the Inspector General.
      • Representation of a Connecticut hospital in connection with quality of care investigation by the Connecticut Department of Public Health. Prepared and defended witnesses in interviews with state investigators, coordinated all aspects of compliance with document demands, and appeared in related individual licensure hearings on behalf of the facility.
      • Representation of an emergency medical service corporation and principals in criminal investigation involving potential Medicare fraud. Avoided prosecution and termination of Medicare participation status through negotiated resolution of civil monetary penalties.
      • Regular representation of institutional health care providers in connection with financial audits and quality of care investigations relating to the Medicaid and Medicare programs conducted by the Connecticut Department of Social Services and the Connecticut Department of Public Health.
      • Representation of health services corporation in connection with liquidation of affiliated health maintenance organization before the Connecticut Insurance Department.
      • Regular representation of hospitals, community providers and physician groups in connection with corporate compliance plans.
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    • News
      • December 11, 2013

        Robinson & Cole Elects Four New Partners and Promotes Six Counsel

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      • November 1, 2013

        Robinson & Cole Receives 34 First-Tier Metropolitan Rankings and Three National Rankings in U.S. News – Best Lawyers Survey

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      • October 21, 2013

        Super Lawyers® Names 61 Robinson & Cole Attorneys to 2013 List

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      • September 3, 2013

        Hartford Office Lawyers Elected to Executive Committee of CBA's Young Lawyers Section

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      • August 16, 2013

        Robinson & Cole Receives Top Listing in Connecticut Attorney Count in Best Lawyers National Peer Review Survey

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      • June 10, 2013

        Chambers USA Ranks Robinson & Cole in Five Practices, Names 17 Attorneys as Leading Lawyers

      • February 11, 2013

        Ted Tucci Quoted in Law360 Article for Health Law

      • December 21, 2012

        Robinson & Cole Attorneys Appointed to Board of Directors of Nonprofits

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      • November 7, 2012

        Robinson & Cole Receives 32 First-Tier Metropolitan Rankings and Four National Rankings in U.S.News - Best Lawyers Survey

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      • October 22, 2012

        Super Lawyers® Names 49 Robinson & Cole Attorneys to 2012 List and Recognizes 26 as Rising Stars

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      • August 28, 2012

        Robinson & Cole Receives Top Listing in Connecticut Attorney Count in Best Lawyers National Peer Review Survey

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      • August 2, 2012

        Ted Tucci on Panel Discussion about the Supreme Court’s Ruling on Health Care

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      • June 30, 2012

        Theodore J. Tucci to Participate in the Metro Hartford Alliance’s Panel Discussion on the U.S. Supreme Court’s Ruling on Health Care Reform

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      • June 7, 2012

        Chambers USA Ranks Robinson & Cole in Five Practices, Names 16 Attorneys as Leading Lawyers

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      • January 19, 2012

        Robinson & Cole Welcomes New Health Law Attorneys

      • October 19, 2011

        Class Dismissed! Appellate Team Wins Summary Judgment for Health Insurer

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      • June 17, 2011

        Chambers USA Ranks Robinson & Cole in Six Practices, Names 12 Attorneys as Leading Lawyers

      • June 14, 2011

        Health Law Attorneys Publish ACO Regulations Article in Connecticut Law Tribune

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      • June 8, 2011

        Robinson & Cole Attorneys Present Webinar on Accountable Care Organizations (ACOs)

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      • May 13, 2011

        Attorneys Present Webinar on Accountable Care Organizations

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      • May 5, 2011

        Robinson & Cole Attorneys Present Medicaid Audit Defense Seminar

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      • December 15, 2010

        Health and Benefits Litigators Win “Appropriate Care” Disability Insurance Case

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      • December 6, 2010

        Health Care Attorneys Talk Strategy with Hospitals

      • November 1, 2010

        VNA Health Care Elects Attorney to Board of Directors

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      • September 17, 2010

        Robinson & Cole LLP Receives Most Connecticut First-Tier Rankings in Inaugural U.S.News - Best Lawyers Survey

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      • August 12, 2010

        Health Law Group Hosted Webinar on New Electronic Health Record Requirements

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      • June 14, 2010

        Robinson & Cole Partner Quoted in Hartford Business Journal on Health Care Reform Impact to Local Businesses

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      • June 4, 2010

        Robinson & Cole Attorneys Author CT Law Tribune Article on Expansion of Fraud and Abuse Laws Under Reform Legislation

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      • May 20, 2010

        Robinson & Cole Attorneys Featured in Health Care Reform Book

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      • April 28, 2010

        Robinson & Cole Attorney Speaks at Regional Economic Development Forum

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      • October 12, 2009

        Connecticut Governor Appoints Robinson & Cole Attorney to Advisory Committee

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    • Publications + Presentations
    • "CMS Releases Statement on Progress of EHR Incentive Programs" (12/13/2013)

      "OIG Report Outlines Concerns Regarding Use of Spinal Devices Provided by Physician-Owned Distributors" (12/11/2013)

      "Developing an Accountable Care Organization; Participating in the Medicare Shared Savings Program," presented at Connecticut Healthcare Financial Management Association Seminar, co-presented by Brian D. Nichols and Meaghan Mary Cooper (11/20/2013)

      "Compliance Date of HIPAA Omnibus Rule Approaching" (08/08/2013)

      "CT DSS Notifies Providers They Must Enroll in Medicaid to Serve Medicaid Beneficiaries" (08/01/2013)

      "OIG Issues Advisory Opinion Permitting Podiatrist-Owned Orthotics Business" (07/30/2013)

      "CT Health Law Legislative Update" (07/16/2013)

      "CT Health Law Legislative Update Supplement" (07/16/2013)

      "Health Law Pulse" (06/26/2013)

      "OIG Releases Revised Provider Self-Disclosure Protocol" (05/07/2013)

      "OIG Releases Special Fraud Alert and EHR Donation Sunset Date" (04/12/2013)

      "CMS Releases Final Sunshine Act Rule" (03/12/2013)

      "Implications of the Final HIPAA Omnibus Rule," co-presented by Brian D. Nichols, Meaghan Mary Cooper and Michael J. Kolosky, webinar (3/5/2013)

      "FTC Issues Favorable Advisory Opinion to Clinically Integrated PHO" (02/28/2013)

      "OIG Issues Advisory Opinions" (02/20/2013)

      "HIPAA Omnibus Rule Released" (02/13/2013)

      "CT AG Consolidates Antitrust and Health Care Fraud Units" (01/22/2013)

      "HHS-OCR Guidance for De-identifying PHI Under HIPAA" (12/18/2012)

      "OIG: Per Diem Call Coverage Payment Not Subject to Sanctions" (12/06/2012)

      "OIG Workplan for Fiscal Year 2013" (10/30/2012)

      "CT DSS Issues Proposed Audit Regulations" (10/18/2012)

      "Service Line Co-Management Arrangements: Models & Practicalities," published in ABA Health eSource, authored by Pamela H. Del Negro (10/2012)

      "Health Law Pulse" (09/27/2012)

      "CT Health Law Special Legislative Session Update" (07/25/2012)

      "NLRB Finds Hospital's No-Access Policy for Off-Duty Employees Unlawful" (07/16/2012)

      "COVID-19 Relief: Understanding SBA Loan Opportunities Under the CARES Act" co-authored by Taylor A. Shea, Endicott Peabody IV (Kit), Frank W. Eucalitto, Jeffrey L. Volpintesta and Barrett P. Wilson-Murphy (4/1/2020)

      "New Regulations for Hospital Conditions of Participation" (07/09/2012)

      "OIG Report Outlines Concerns Regarding Use of Spinal Devices Provided by Physician-Owned Distributors" (12/11/2013)

      "CT Health Law Legislative Update" (06/11/2012)

      "Health Law Pulse" (06/01/2012)

      "OSHA Focuses on Nursing and Residential Care Facilities" (04/23/2012)

      "CMS Issues Proposed Rule on Stage Two Meaningful Use" (03/13/2012)

      "Health Law Pulse" (03/01/2012)

      "Federal Agency Guidance on ACOs Released" (11/22/2011)

      "Antitrust Lessons from Interplay of Hospitals, Doc Groups," (4/8/2013)

      "Health Law Pulse" (10/18/2011)

      "CT Health Law Legislative Update Part 2" (08/19/2011)

      "CT Health Law Legislative Update Part 1" (07/14/2011)

      "Health Law Pulse" (06/24/2011)

      "New Entities Will Coordinate Medicare Coverage," published in Connecticut Law Tribune, co-authored by Pamela H. Del Negro and Meaghan Mary Cooper (5/16/2011)

      "Guidance Released on Accountable Care Organizations Participating in the Medicare Shared Savings Program" (05/13/2011)

      "Finally! Some Enlightenment on Accountable Care Organizations: Proposed Rules Issued," co-presented by Lisa M. Boyle and Kimberly E. Troland and Moses Vargas (4/27/2011 and 5/4/2011)

      "Legal and Strategic Considerations in Defending Medicaid Audits," at Connecticut Community Providers Association, co-presented by Theodore J. Tucci Michael J. Kolosky (4/27/2011)

      "Federal Agencies Release Guidance on Accountable Care Organizations" (04/21/2011)

      "Health Law Pulse" (03/10/2011)

      "Horizontal Merger Guidelines Revised" (10/19/2010)

      "Health Law 2010 Legislative Update" (07/15/2010)

      "New "Patient's Bill of Rights" Issued under Patient Protection and Affordable Care Act" (07/07/2010)

      "Health Care Reform Update" (04/12/2010)

      "President Obama Announces New Efforts to Crack Down on Fraud" (03/22/2010)

      "Vermont Supreme Court Upholds Suspension of Physician's License Despite Due Process" (02/12/2010)

      "Recovery Audit Contractor (RAC) Program" (12/28/2009)

      "CMS Issues Memorandum on Compliance with EMTALA During a Potential H1N1 Emergency" (12/28/2009)

      "Massachusetts Court Interprets Mental Health Professional "Duty to Warn Statute"" (12/28/2009)

      "Enforcement of Red Flags Rule Has Been Delayed Again" (11/09/2009)

      "New Connecticut False Claims Act" (11/09/2009)

      "Health Law 2009 Legislative Update" (09/21/2009)

      "Interim Final Regulations Clarify HITECH's Breach of Health Information Notification Requirements" (09/03/2009)

      "Enforcement of Red Flags Rule Has Been Delayed" (07/30/2009)

      "HHS Issues Guidance on Technologies and Methodologies that Render Protected Health Information Secure" (07/29/2009)

      "Enforcement of Federal Trade Commission Red Flag Rules Delayed" (05/19/2009)

      "Health Care Entities that Extend Credit to Patients Must Implement Identity Theft Prevention Program" (04/27/2009)

      "Health Care Implications of Federal Stimulus Plan" (03/09/2009)

      "Red Flag Rules' Effective Date Has Been Delayed" (10/24/2008)

      "Health Law 2008 Legislative Update" (09/03/2008)

      "A Guide to Connecticut’s Certificate-of-Need Process," published in Connecticut Medicine Magazine, co-authored by Brian D. Nichols and Theodore J. Tucci (June/July 2008)

      "Health Law Pulse" (06/11/2008)

      "The Joint Commission Suspends the Implementation of Revised Standard MS 1.20" (06/11/2008)

      "CT Department of Public Health Adopts New Regulations for Reporting Adverse Events within Hospitals and Outpatient Surgical Facilities" (02/29/2008)

      "Health Law Pulse" (11/06/2007)

      "Health Law Pulse" (08/09/2007)

      "Health Law Pulse" (06/27/2007)

      "States divided over asset purchases and non-competes," published in New England In-House, more details (1/2010)

      "Health Law Pulse" (03/26/2007)

      "Health Law Pulse" (02/15/2007)

      "Health Law Pulse" (11/27/2006)

      "Health Law Pulse" (07/31/2006)

      "Health Law Pulse" (06/20/2006)

      "Health Law Pulse" (05/24/2006)

      "e-News" (08/24/2005)

      "e-News" (06/10/2005)

      "e-News" (03/29/2005)

      "e-News" (11/22/2004)

      "e-News" (10/08/2004)

      "e-News" (09/20/2004)

      "e-News" (08/09/2004)

      "e-News" (04/06/2004)

      "e-News" (11/10/2003)

      "e-News" (09/25/2003)

      "Confidentiality," at Mental Health and the Law, A Health Education Network program, presented by Meaghan Mary Cooper

      "Medical Records Law," at Lorman Education Services program, presented by Meaghan Mary Cooper (3/14/2013; 4/11/2012)

Our Team

Chair

Members