Nicole represents clients in complex litigation matters across a variety of areas including health care enforcement defense, white collar defense, and general commercial litigation in state and federal court. Her practice focuses on defending clients, including laboratories, health plans and Medicare Advantage plans in government investigations of alleged violations of the False Claims Act (FCA) and similar state statutes, conducting internal investigations, and litigating qui tam FCA cases. In addition, Nicole is experienced in electronic discovery, and frequently handles large data matters during civil and criminal litigation and governmental inquiries.
Prior to joining Mintz, Nicole worked as a legal extern in the National Security Division, Counterterrorism Section of the US Department of Justice. Nicole also served as a law clerk in the Office of the Chief Counsel of Immigration and Customs Enforcement at the US Department of Homeland Security, where she litigated cases before immigration judges. While in law school, Nicole was a member of The George Washington International Law Review. Nicole also served as a writing fellow and as a vice president of the Student Bar Association.
Before earning her law degree, Nicole worked as an intern with the US Department of State Office of Civil Rights. She also worked as a legal assistant at a Virginia law firm, where she supported attorneys who specialize in workers’ compensation law.
Education
- George Washington University (JD, with honors)
- George Mason University (BA, magna cum laude)
Recognition & Awards
- The George Washington University Law School, Presidential Volunteer Service Award (2017)
- The George Washington University Law School, First Year Moot Court Competition Best Brief Award (2015)
- Phi Kappa Phi Honor Society (2012 – 2014)
Recent Insights
Viewpoints
COVID-19 Relief Programs: Mitigating and Responding To Enforcement Risk
June 22, 2020|Blog
Health Care Enforcement Year-in-Review and 2020 Outlook: Criminal Case Developments
January 22, 2020|Blog
News & Press
Mintz Member Eóin Beirne and Associates Jason Burrell and Nicole Henry co-authored this Law360 expert analysis article examining trends and developments in criminal health care enforcement in 2019, such as opioid-related enforcement, kickbacks and medical necessity, medical devices, U.S. Department of Justice guidance, and more. The article also posits criminal health care enforcement trends for 2020, including the increased use of data-driven investigative tools, continued opioid prosecutions, and scrutiny of new technologies or novel ways of delivering medical care.
Viewpoints
COVID-19 Relief Programs: Mitigating and Responding To Enforcement Risk
June 22, 2020 | Blog | By Brian Dunphy, Jane Haviland, Nicole Henry, Karen Lovitch
Since the early days of the pandemic, Mintz’s COVID-19 Compliance & Enforcement Defense Task Force has closely monitored and advised clients on the evolving COVID-19 relief programs, including those created by the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The CARES Act provided for over $2 trillion in relief funds, which is the largest emergency assistance package in American history. The numerous CARES Act programs have continued to develop through, among other things, the passage of the Paycheck Protection Program and Health Care Enhancement Act, the Paycheck Protection Program Flexibility Act of 2020, and rapidly changing regulatory guidance and FAQs. As one example, the government recently wrestled with whether to make public the list of about 4.6 million entities that received more than $500 billion from the Paycheck Protection Program (PPP) under the CARES Act. After initially refusing to disclose PPP loan recipients, the Small Business Administration and Treasury Department decided to make public the names of entities that received loans larger than $150,000, as well as the dollar range of each loan.
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DOJ Files False Claims Act Lawsuit Against Anthem for “One-Sided” Chart Review Practices
April 7, 2020 | Blog | By Brian Dunphy, Nicole Henry
The Department of Justice recently filed suit against Anthem, Inc. (Anthem) alleging that the Medicare Advantage Organization (MAO) violated the False Claims Act when it knowingly failed to delete inaccurate diagnosis codes submitted to the Centers for Medicare and Medicaid Services (CMS) for risk adjustment purposes. As predicated in our 2020 outlook post, we continue to see enforcement activity and ongoing litigation against Medicare Advantage plans. Notably, this trend is referenced in SDNY’s complaint, alleging that the government has “sought to enforce” data accuracy in the risk adjustment system by “actively pursuing legal remedies against [] MAOs that have knowingly submitted inaccurate and untruthful diagnosis data to CMS[.]” The complaint provides four examples of settlements obtained from 2012-2019 against MAOs and healthcare providers who, purportedly like Anthem, submitted inaccurate diagnosis codes to CMS or allegedly failed to delete unsupported diagnosis codes.
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Health Care Enforcement Year-in-Review and 2020 Outlook: Criminal Case Developments
January 22, 2020 | Blog | By Eoin Beirne, Nicole Henry, Jason Burrell, Jane Haviland
As discussed in our article recently published by Law360, criminal health care enforcement in 2019 was in many ways a continuation of 2018, with opioid-related enforcement continuing to be the clear top priority for the Department of Justice (DOJ), in addition to DOJ's sustained focus on prosecuting individuals and data-driven identification of health care fraud. This post provides an overview of our article, which covers these issues and our expectations for 2020 in detail.
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Health Care Enforcement Year-in-Review and 2020 Outlook: Civil Fraud Enforcement Developments and Trends
January 21, 2020 | Blog | By Brian Dunphy, Laurence Freedman, Karen Lovitch, Julianna Hanlon, Nicole Henry, Clare Prober
As discussed in our article recently published by Law360, 2019 brought yet another year of robust health care enforcement activity, and the False Claims Act (FCA) remains the government’s most powerful civil health care enforcement tool. This post will give an overview of our article, which covers these issues and more in great detail.
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Third Circuit Says the FCA Does Not Guarantee A Hearing When DOJ Seeks to Dismiss Declined FCA Cases
September 24, 2019 | Blog | By Nicole Henry
The Court of Appeals for the Third Circuit recently weighed in on a relator’s right to a hearing where the government moves to dismiss a declined qui tam case, holding that the False Claims Act (FCA) does not guarantee a relator an in-person hearing before their declined FCA cases may be dismissed.
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Third Time’s Not the Charm: Supreme Court Again Declines to Weigh in on Escobar’s “Materiality” Standard
March 25, 2019 | Blog | By Brian Dunphy, Nicole Henry
The Supreme Court denied a petition for certiorari last Monday in U.S. ex rel. Prather v. Brookdale Senior Living Communities, Inc., No. 17-5826 (6th Cir. June 11, 2018), again declining to revisit or clarify the False Claims Act's “materiality” standard set forth in its 2016 decision in Universal Health Services v. United States ex rel. Escobar, 136 S. Ct. 1989 (2016).
In Prather, the relator alleged that defendant Brookdale Senior Living Communities, Inc. (Brookdale), a home health provider, submitted bills for medical services that were “untimely” signed and certified by physicians in violation of Medicare regulations. When submitting Medicare claims, Brookdale purportedly did not obtain the required physician certifications attesting that the medical services provided by Brookdale were necessary until months after establishing a patient’s plan of care. Because Medicare regulations under 42 C.F.R. § 424.22(a)(2) require physician certifications “at the time the plan of care is established or as soon thereafter as possible,” the relator alleged that Brookdale’s untimely certifications rendered the claims false under the implied false certification theory. The district court dismissed the complaint on materiality grounds, holding that the noncompliance was insubstantial and that the relator failed to allege that the government had ever denied a claim based on a violation of the timing requirement under the Medicare regulations.
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In Prather, the relator alleged that defendant Brookdale Senior Living Communities, Inc. (Brookdale), a home health provider, submitted bills for medical services that were “untimely” signed and certified by physicians in violation of Medicare regulations. When submitting Medicare claims, Brookdale purportedly did not obtain the required physician certifications attesting that the medical services provided by Brookdale were necessary until months after establishing a patient’s plan of care. Because Medicare regulations under 42 C.F.R. § 424.22(a)(2) require physician certifications “at the time the plan of care is established or as soon thereafter as possible,” the relator alleged that Brookdale’s untimely certifications rendered the claims false under the implied false certification theory. The district court dismissed the complaint on materiality grounds, holding that the noncompliance was insubstantial and that the relator failed to allege that the government had ever denied a claim based on a violation of the timing requirement under the Medicare regulations.
News & Press
2019 Trends In DOJ Health Care Enforcement
January 13, 2020
Mintz Member Eóin Beirne and Associates Jason Burrell and Nicole Henry co-authored this Law360 expert analysis article examining trends and developments in criminal health care enforcement in 2019, such as opioid-related enforcement, kickbacks and medical necessity, medical devices, U.S. Department of Justice guidance, and more. The article also posits criminal health care enforcement trends for 2020, including the increased use of data-driven investigative tools, continued opioid prosecutions, and scrutiny of new technologies or novel ways of delivering medical care.