Fraud & Abuse

No one defends healthcare providers against allegations of healthcare fraud and abuse better than Nelson Hardiman. The increasing size, scope, and aggressiveness of recent fraud investigations and prosecutions by the federal government, the State of California and private health insurers makes the need for experienced and sound counsel greater than ever.

We have defended countless fraud and abuse investigations. We are widely regarded as one of the most prominent fraud and abuse law firms in California, a reputation earned representing health care providers on all facets of criminal investigations and charges, civil False Claims Act (FCA) and fraud allegations, and administrative proceedings.

Our exemplary track record testifies to our keen knowledge and experience of healthcare compliance issues, including Medicare, Medi-Cal, and private insurance coverage. We develop compliance programs that minimize the risk of fraud and abuse investigations, counsel health care providers on how to avoid allegations, and how to respond when they arise, making us the go-to law firm to handle fraud and abuse investigations.

Our Work Includes:

  • Fraud and Abuse Represented a large ambulance company in a government fraud investigation involving over a million documents, and assisted with creating cost-analyses to rebut government theories of false claims liability.
  • Fraud and Abuse Compliance Advised a large nonprofit hospital corporation in its comprehensive internal Stark Law review and self-disclosure of more than 2,000 physician compensation arrangements.
  • Medical Board of California Successfully resolved an investigation by Operation Safe Medicine, a project of the Medical Board of California, helping a doctor avoid criminal prosecution by addressing a physician compliance issue involving medical marijuana recommendations.
  • Medicare Defended Medicare fraud investigations by the Office of the Inspector General (OIG).
  • Medi-Cal Defended fraud investigations by the Department of Health Care Services (DHCS) and Bureau of Medi-Cal Fraud and Elder Abuse (BMFEA).