Fraud & Abuse, Stark, Anti-Kickback Counseling and Defense

Hooper, Lundy & Bookman has some of the nation’s most experienced and highly regarded experts in the federal physician self-referral statute (the “Stark” law), the federal anti-kickback statute, and the state law equivalents. The firm’s attorneys have handled many of the most significant Stark and fraud and abuse cases in the country. For example, our firm handled the landmark case of Hanlester Network v. Shalala, 51 F.3d 1390 (9th Cir. 1995), which is the only federal case to apply the anti-kickback statute to a physician-owned joint venture.

Our firm represents a broad spectrum of health care providers and suppliers on Stark law and anti-kickback statute issues, including hospitals and hospital systems throughout the country, as well as some of the largest device and pharma companies in the world.

Our lawyers have lectured and published widely on the Stark and fraud and abuse laws. Attorneys in our firm, for example, have authored the leading treatises published by the Bureau of National Affairs (BNA) on the federal anti-kickback law and the Stark law, and have published numerous law review articles on these subjects. A partner in the firm also wrote the 2014 American Health Lawyers Association Monograph on the Stark Law, the fifth edition of a treatise he first wrote in 1998. The firm’s attorneys have also served as expert witnesses on Stark law and fraud and abuse matters, in both arbitration and litigation, including civil and criminal proceedings. In addition, we have a multi-disciplinary working group, the Fraud & Abuse Practice Group, that meets regularly for members to share insights and updates.  

We provide the following services related to Stark and fraud and abuse issues:

• Structuring and implementing all types of hospital/physician financial relationships, contracts and transactions;
• Designing compliance, programs, policies and procedures to address Stark and fraud and abuse laws;
• Unwinding transactions, as necessary, to address changing regulatory standards;
• Hospital/physician joint ventures, mergers and acquisitions;
• Management agreements and other physician alignment models;
• Physician recruitment and retention arrangements, including developing policies and procedures, providing counseling advice, and drafting and negotiating documents;
• Conducting internal investigations to determine whether violations of the Stark or fraud and abuse laws have occurred;
• Assisting clients with implementing any necessary corrective action, up to and including self-disclosures to governmental authorities when appropriate;
• Preparing, submitting, and obtaining approval on a number of fraud and abuse and Stark advisory opinion requests;
• Working extensively with state and national trade organizations and other clients in commenting on, revising, and drafting regulations and legislation in the area of health care fraud and abuse, including guiding bills through the legislative process.