Health Care Enforcement Year in Review & 2021 Outlook

By Eoin P. Beirne, Brian P. Dunphy, Karen S. Lovitch, Kevin M. McGinty, Samantha P. Kingsbury, Keshav Ahuja, Grady R. Campion, Jane T. Haviland, Caitlin A. Hill

Mintz’s Health Care Enforcement Defense team has produced a comprehensive overview of the key policy issues, statistics, settlements, and court decisions related to health care fraud enforcement in 2020, along with predictions about enforcement activity in this area in 2021 and beyond. We reviewed statistical data published by the Department of Justice (DOJ), our internal database of health care–related qui tam cases, DOJ enforcement actions, and significant federal agency actions and guidance connected to health care enforcement.
Health Care Enforcement Report Graphic
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Our report provides an in-depth look at statistical trends in civil False Claims Act litigation in 2020 and the government’s health care fraud enforcement priorities last year, which included matters involving opioids, COVID-19 related fraud, and Medicare Advantage, among others. It also discusses major agency guidance over the past year and concludes with a summary of how we expect health care enforcement to evolve over the coming year under the new Biden administration.

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Eoin P. Beirne

Member / Co-chair, White Collar Defense and Government Investigations Practice

Eóin P. Beirne is co-chair of Mintz’s White Collar Defense and Government Investigations group. He guides clients from a wide range of industries through federal and state investigations and enforcement proceedings.

Brian P. Dunphy

Member / Co-Chair, Health Care Enforcement Defense Practice

Brian P. Dunphy is a member of the Health Care Enforcement & Investigations Group at Mintz. He defends clients facing government investigations and whistleblower complaints regarding alleged violations of the federal False Claims Act. Brian also handles commercial health care litigation.

Karen S. Lovitch

Chair, Health Law Practice & Co-Chair, Health Care Enforcement Defense Practice

Karen advises industry clients on regulatory, transactional, operational, and enforcement matters. She has deep experience handling FCA investigations and qui tam litigation for laboratories and diagnostics companies.

Kevin M. McGinty

Member / Co-chair, Class Action Practice

Kevin is a member of the firm's Health Care Enforcement Defense Group and has significant experience representing health care–related entities in a variety of litigation matters, including contract, regulatory, False Claims Act and class action lawsuits. Kevin's health care industry clients have included pharmacies, PBMs, hospitals, clinical laboratories, diagnostic imaging providers, pharmaceutical companies and managed care organizations.

Samantha P. Kingsbury

Of Counsel

Samantha advises clients on regulatory and enforcement matters. She has deep experience handling violations of the federal ant-kickback statute and FCA investigations for clinical laboratories and hospitals.

Keshav Ahuja

Associate

Keshav Ahuja is an attorney at Mintz who focuses his practice on complex commercial litigation, securities litigation, class actions, and other litigation matters.

Grady R. Campion

Associate

Grady R. Campion is a Mintz attorney who focuses his practice on complex commercial litigation and white collar matters. He represents clients in a variety of industries, including financial services.

Jane T. Haviland

Associate

Jane Haviland's practice focuses primarily on health care enforcement defense. Jane defends laboratories, physicians, and other clients facing government investigations and whistleblower complaints regarding alleged violations of the federal False Claims Act, the federal anti-kickback statute, the Stark law, and similar state laws.

Caitlin A. Hill

Member

Caitlin A. Hill is a Mintz attorney who practices complex litigation including contract disputes, commercial and business litigation, complex tort and product liability litigation, and construction law. She advises contractors, owners, developers, and public authorities in all stages of litigation.