Fraud & Abuse

Nelson Hardman fiercely defends healthcare providers from devastating allegations of healthcare fraud and abuse on a daily basis. We litigate, case-by-case, through victories and favorable resolutions, every facet of criminal investigations and charges, civil False Claims Act (FCA) fraud and abuse actions.

Few law firms can boast Nelson Hardiman’s experience in defending healthcare providers against allegations of fraud and abuse. Mark Hardiman, who leads Nelson Hardiman’s fraud and abuse practice area, is widely known among healthcare providers as the go-to defense lawyer for difficult and high-stakes Medicare and Medi-Cal fraud cases and is regarded as one of the most prominent fraud and abuse defense attorneys in California.

We have successfully represented countless individual physicians and healthcare facilities against fraud and abuse allegations in many of the leading cases filed in Southern California. And we have won significant victories at trial and on appeal and negotiated countless favorable settlements with federal and state regulatory agencies.

Our Work Includes:

  • False Claims Act (FCA) Won an FCA case decisively on summary judgment for a large Southern California hospital when two whistleblowers from a rival laboratory alleged the hospital’s kidney transplant program had submitted millions of dollars in Medicare claims for duplicative and unnecessary histocompatibility testing for transplant candidates.
  • Federal Civil RICO Lawsuits Represented multiple providers in major “civil RICO” lawsuits brought by out-of-state health insurance companies against California physicians accused of cooperating with dishonest clinic managers in performing unnecessarily.
  • Whistleblower Litigation Advised a national health system in FCA litigation filed by a whistleblower alleging the health system submitted false Medicare claims for inpatient admissions that should have been billed as observation care (“short stay” claims) and/or false diagnoses to increase reimbursement.