Health Care Fraud & Abuse for Law Firms

Law firms can turn to T&M’s Health Care Fraud & Abuse (HCFA) unit for experienced and professional litigation support services in response to regulatory and health care plan audits and inquiries. HCFA’s experts provide independent examinations and coding reviews through proactive, on-site exposure analyses of current billing records and practices and offer mitigation strategies for any adverse discoveries. In addition, they conduct specialized interviews by Accredited Health Care Fraud Investigators, medical professionals and others.

HCFA assists in litigation resulting from:

  • Medicare and Medicaid audits, such as audits emanating from a state’s Office of the Medicaid Inspector General (OMIG);
  • The U.S. Department of Health & Human Services Office of Inspector General (OIG);
  • A state’s Medicaid Fraud Control Unit (MFCU);
  • Zone Program Integrity Contractors (ZPIC);
  • A state’s Medicaid Integrity Contractor (MIC); and
  • Criminal and civil investigations involving the Stark Law, anti-kickback laws, the False Claims Act, qui tam actions and other regulatory actions.

T&M’s HCFA team is comprised of Accredited Healthcare Fraud Investigators (AHFI’s) certified by the National Health Care Anti-Fraud Association, Certified Fraud Examiners (CFE’s) certified by the Association of Certified Fraud Examiners, Certified Public Accountants (CPA’s), Certified Professional Coders (CPC), clinical reviewers and former prosecutors and law enforcement executives who are recognized industry experts in their fields with extensive healthcare management and field operations experience.

See also Health Care Fraud & Abuse for MCO’s, IPA’s and Medical Providers.