Healthcare Investigations

Healthcare organizations operate in one of the country’s most heavily regulated industries. Allegations of fraud, billing irregularities, or regulatory noncompliance can quickly escalate into government investigations, civil enforcement actions, or criminal proceedings. Dickinson Wright helps healthcare providers, organizations, and executives respond to these matters while minimizing disruption to their operations and protecting their long-term interests.

Our team represents clients in investigations involving the U.S. Department of Justice, the Office of Inspector General (OIG), the Centers for Medicare & Medicaid Services (CMS), state attorneys general, Medicaid Fraud Control Units, and other federal and state agencies. We also help organizations strengthen compliance programs to reduce regulatory risk before issues arise.

Our Services

• Government Investigations: Representation in federal, state, and local investigations, including responses to subpoenas, civil investigative demands, search warrants, grand jury proceedings, and agency inquiries.
• Healthcare Fraud Defense: Defense of False Claims Act, Anti-Kickback Statute, Stark Law, Medicare, Medicaid, TRICARE, billing fraud, and other healthcare fraud matters.
• Compliance & Internal Investigations: Compliance program development, internal investigations, compliance audits, risk assessments, and employee training.
• Self-Disclosure & Regulatory Counseling: Guidance on self-disclosures, voluntary reporting, provider enrollment, licensure, certification, Corporate Integrity Agreements, and ongoing regulatory compliance.
• Litigation & Enforcement Defense: Representation in civil, criminal, and administrative proceedings, including parallel government investigations and enforcement actions.

Who We Represent

We represent hospitals, health systems, physician and dental practices, academic medical centers, pharmacies, durable medical equipment providers, healthcare technology companies, pharmaceutical and medical device companies, nonprofit organizations, and healthcare executives.

Our Team

Our team includes former federal and state prosecutors alongside attorneys with extensive healthcare regulatory experience. We understand how investigations develop, how enforcement agencies evaluate cases, and how to help clients respond effectively while managing operational and regulatory risks.

Representative Matters

• Obtained a decision not to file charges against the CEO of a publicly traded healthcare company during a federal criminal investigation conducted in parallel with an SEC investigation.
• Represented the owner of a durable medical equipment company in federal healthcare fraud proceedings involving alleged Medicare overbilling, resulting in a probationary sentence.
• Conducted an investigation involving an alleged $6 million Medicaid and education funding fraud scheme related to improper billing for special education services.
• Represented the owner of a durable medical equipment company in connection with allegations of inflated Medicare and Medicaid reimbursement claims.
• Investigated claims involving alleged misrepresentations by medical device manufacturers regarding product performance and efficacy.
• Represented specialty pharmacy owners in matters involving allegations of employee embezzlement and related investigations.
• Negotiated favorable resolutions with multiple government agencies, including Corporate Integrity Agreements, to resolve regulatory investigations while allowing clients to continue operating.