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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.

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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Authors

Eoin P. Beirne

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

Eóin P. Beirne is a white collar defense lawyer at Mintz. He guides clients from a wide range of industries through investigations and enforcement proceedings and represents them in state and federal courts. Eóin handles matters related to health care fraud, public corruption, and insider trading.
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

Member / Chair, Health Law Practice

Karen S. Lovitch is a Mintz attorney who represents health care companies in regulatory, transactional, and operational matters. She advises them on health care regulations such as the Stark Law and the Clinical Laboratory Improvement Amendments of 1988.

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 is a Mintz attorney who focuses on health care enforcement defense matters, representing clients in criminal and administrative actions. She also assists clients with internal investigations, and she has experience preparing self-disclosures and other enforcement reports.

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 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 is a Mintz attorney who handles litigation matters, including complex civil and business litigation and product liability law. She has contributed to litigation victories including multijurisdictional product liability disputes involving pharmaceutical drugs.

Caitlin A. Hill

Associate

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.
Rebecca L. Zeidel is a Mintz attorney who handles litigation matters, including securities litigation, insurance disputes, complex civil litigation, government investigations, and white collar criminal defense. In 2016, she served as a Special Assistant District Attorney in Middlesex County.