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Health Care

Health care regulation and compliance is governed by a Byzantine network of laws and regulations. Our attorneys at Kaplan Johnson Abate & Bird LLP have experience in health care matters that runs the gamut from regulatory and compliance advice and transactions, to investigations and litigation.

Experience Resolving Complex Health Care Matters

Experience has taught us that truly effective representation with these matters requires health care attorneys with the highest level of skill and knowledge. Our attorneys include practitioners who graduated from top-tier schools, clerked for federal judges, and worked in the Department of Justice.

This experience serves us well in working with federal authorities in Kentucky and elsewhere in negotiating, resolving, and litigating matters involving alleged fraud and abuse issues such as Medicare billing concerns, Stark Law violations, and anti-kickback violations.

Assistance with Regulatory, Compliance and Risk Management

We also work with attorneys in our corporate and real estate practice group to negotiate and structure transactions such as leases, acquisitions, and management agreements. We counsel clients on the regulatory, compliance, and risk management aspects of these transactions, using strategies to help our clients achieve goals in the most efficient and practical manner possible without creating undue complexity for the organization.

Clients include providers at all levels, including institutional, group practice, and individuals. Health care services we provide include:

  • Medicare fraud and abuse
  • Stark law
  • Corporate compliance, audits, and self-disclosure
  • Physician and other provider contracts
  • Acquisitions
  • Management and service contracts
  • Medical staff and credentialing issues
  • Licensure issues
  • Administrative hearings

Representative Matters

  • Aetna Life Ins. Co. v. Big Y Foods, Inc., 52 F. 4th 66 (2nd Cir. 2022): Successfully defended double-damages judgement for a Medicare Advantage Organization against a primary payer under the Medicare Secondary Payer law.
  • Humana Health Plan, Inc. v. Anthem Kentucky Managed Care Plan, Inc., No 2021-CA-0819 (Sept. 9, 2022): Obtained reversal of opinion setting aside results of Kentucky’s multi-billion-dollar Medicaid Managed Care procurement.

Contact Us

We counsel and represent clients in Metro Louisville and throughout the nation. To speak with one of our lawyers, call our office at 502-416-1630.