Health Litigation and Administrative Advocacy

Overview

Health care providers and companies involved in the health care industry face unique legal and business risks. Keeping pace with the business and regulatory challenges of health care in today's competitive environment is more important than ever in this fast-changing age of health care reform.

Robinson+Cole's Health Law Group offers a dedicated team of litigation lawyers with a comprehensive understanding of health care-related litigation and disputes as well as of the health care industry in general. Our health litigation and administrative advocacy lawyers work with clients not only to achieve success in litigation but also to manage and reduce risk and meet our clients' business objectives. We represent health care entities in civil and criminal litigation, arbitration, administrative agency actions, and appeals.

Our Services and Our Team

The lawyers in our Health Law Group represent all types of clients in the health care industry, including the following:
•  for-profit and nonprofit health care providers and hospital systems
•  home health agencies
•  nursing homes
•  pharmaceutical manufacturers and retail pharmacies
•  outpatient and imaging centers
•  assisted living facilities
•  human services agencies

We deal with all manner of litigation and regulatory matters, including in these areas:
•  antitrust claims
•  commercial and class action litigation
•  commercial disputes
•  class actions against health system clients
•  state and federal government investigations
•  reimbursement and recoupment actions by government payors and contracted auditors
•  fraud, abuse, and whistleblower claims
•  data breach regulatory investigations and litigation
•  medical staff and credentialing disputes
•  pharmaceutical market conduct litigation

In addition, Robinson+Cole lawyers handle state and federal civil and criminal health care investigations conducted by these entities:
•  state lawyers
•  general and Medicaid fraud units
•  the U.S. Attorney's Office and the Department of Justice
•  the Department of Health and Human Services, Office of Inspector General
•  the Federal Bureau of Investigation

In representing the litigation and risk management needs of our health care clients, members of our Health Law Group appear in matters before state and federal courts, state Medicaid agencies, and state and federal regulatory and licensure agencies.
 

    • Experience
      • Represented one of Connecticut’s largest providers of home health services in connection with a multi-agency federal and state investigation into the company’s billing practices. Worked closely with the client to conduct an internal investigation of the agency’s billing processes to identify potential areas of exposure and to develop a comprehensive corporate compliance program. Successfully persuaded the United States Attorney’s Office not to pursue charges and to issue a formal declination letter.
      • Represented Connecticut hospital in connection with quality of care investigation by the Department of Public Health. Prepared and defended witnesses in interviews with state investigators, coordinated all aspects of compliance with document demands, and appeared in related individual licensure hearings on behalf of the hospital.
      • Represented emergency medical service corporation and principals in criminal investigation involving potential Medicare fraud. Avoided prosecution and termination of Medicare participation status through negotiated resolution of civil monetary penalties.
      • Represented a hospital network and behavioral health center in an investigation of billing practices brought by the Federal Bureau of Investigation and the Office of the Inspector General.
      • Represented hospital in claim by surgeon of wrongful termination of staff privileges. Defended case successfully through administrative hearings, trial and appeal to Connecticut Supreme Court, establishing legal standard of substantial compliance with bylaws hearing procedures.
      • Represented hospital in claim of wrongful failure to certify resident’s successful completion of surgical residency program. Defended case successfully through administrative hearings, trial and appeal, establishing legal standard rejecting educational malpractice claim and establishing hospital’s discretion to make professional competence determinations.
      • Regularly advise and represent hospitals in peer review matters and administrative proceedings under medical staff bylaws to terminate, reduce or suspend clinical privileges.
      • Regularly serve as counsel to hearing committees or as hearing officer in administrative proceedings under medical staff bylaws to terminate, reduce or suspend clinical privileges.
      • Defended hospital in class action case brought on behalf of deaf and hearing impaired community. Negotiated settlement with Connecticut Attorney General and United States Justice Department to improve systemwide access to health services for deaf and hearing impaired patients.
      • Ongoing representation of major pharmaceutical manufacturer in a lawsuit brought by the Connecticut Attorney General seeking recovery of Medicaid and Medicare payments made for certain pharmaceuticals.
      • Represented substance abuse treatment center before municipal land use commissions in defending against zoning enforcement actions. Obtained order from federal court allowing clients to continue making off campus housing available to their patients.
      • Ongoing representation of a physician-hospital organization and affiliated independent practitioner association in a multi-party medical malpractice lawsuit.
      • Defended hospital in class action litigation alleging violation of state statutes relating to medical records requests. Negotiated binding resolution of class action for nominal financial cost.
      • Represented state’s only freestanding children’s hospital in certificate of need proceedings involving relocation of hospital, construction of new facility and combination of fragmented regional pediatric care.
      • Represented hospital in certificate of need proceeding to secure major expansion of cardiac care to include open heart surgery and angioplasty.
      • Regularly appear before the Connecticut Office of Healthcare Access in connection with contested certificate of need matters, change in control, capital expenditures and other regulatory hearings.
      • Regularly advise and represent clients in administrative licensure investigations and proceedings before the Connecticut Department of Public Health. Experience includes negotiation of consent agreements, compliance audit counseling and adverse event investigations.
      • Regularly advise and represent clients in proceedings before the Connecticut Department of Social Services regarding financial audits, administrative sanctions and Title XIX appeals.
      • Handled and prevailed in individual and in consolidated reimbursement appeals cases before administrative law judges for the U.S. Department of Health and Human Services, for national hospice provider.

      • Investigated and filed PSR (Stark law) and excluded individual self disclosures with CMS and the Office of Inspector General (OIG) on behalf of clients.

      • Negotiated settlements with the U.S. Department of Justice, the Centers for Medicare & Medicaid Services, and state Medicaid offices in termination and enrollment actions.

      • Advised on disclosures and settlements with the Health and Human Services (HHS) Office of Inspector General (OIG) in matters involving exclusions.

      • Obtained temporary restraining orders in federal court in hospital Medicare termination actions on behalf of national health care company with acute care and psychiatric hospitals.

      • Handled HIPAA investigations, and provided advice regarding potential HIPAA breaches, with the Office for Civil Rights (OCR) for hospitals, physician practices, and home care companies.

      • Negotiated favorable settlement of a criminal and civil action with the U.S. Food and Drug Administration (FDA) on behalf of an international medical device manufacturer involving allegations of violations of Good Manufacturing Practices (GMP).

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    • News
      • August 17, 2023

        78 Robinson+Cole Lawyers Listed in The Best Lawyers in America© 2024

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      • April 14, 2016

        Robinson+Cole Lawyers Present an Update on Managed Care Litigation

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      • November 3, 2015

        Robinson+Cole Recognized in Benchmark Litigation 2016

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      • July 20, 2015

        Robinson+Cole Lawyers Author Chapter for ABA Book

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      • October 21, 2013

        Super Lawyers® Names 61 Robinson & Cole Attorneys to 2013 List

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      • June 30, 2012

        Theodore J. Tucci to Participate in the Metro Hartford Alliance’s Panel Discussion on the U.S. Supreme Court’s Ruling on Health Care Reform

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      • June 15, 2012

        Robinson & Cole Attorneys Win False Claims Act Cases

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      • June 7, 2012

        Chambers USA Ranks Robinson & Cole in Five Practices, Names 16 Attorneys as Leading Lawyers

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      • June 8, 2011

        Robinson & Cole Attorneys Present Webinar on Accountable Care Organizations (ACOs)

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      • May 14, 2010

        Robinson & Cole Attorney Speaks at Healthcare Reform Program

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      • August 13, 2008

        Robinson & Cole Attorneys Publish Article in Connecticut Medicine Magazine

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    • Publications + Presentations
    • "CMS Releases Final Sunshine Act Rule" (03/12/2013)

      "FTC Issues Favorable Advisory Opinion to Clinically Integrated PHO" (02/28/2013)

      "HIPAA Omnibus Rule Released" (02/13/2013)

      "CT DSS Issues Proposed Audit Regulations" (10/18/2012)

      "Health Law Pulse" (06/01/2012)

Our Team

Chair

Members