Phone: 302.658.4265
Health Law

Health Care Fraud Investigations and Litigation

The health care industry is complex, constantly changing, and one of the most heavily regulated sectors of the economy.

In this challenging environment, Balick & Balick offers experienced and practical legal advice to a broad range of health care clients, including medical professionals and practices, hospitals and health systems, long-term care facilities, ambulatory surgery centers, and medical billing and management companies. Whether dealing with federal and state enforcement agencies, state licensure boards, or Delaware regulatory commissions, our attorneys have extensive experience navigating Delaware’s health law landscape.

The U.S. Department of Justice has declared health care fraud to be one of its highest priorities, and federal and state authorities are devoting unprecedented resources to investigating and prosecuting health care providers. Authorities are also actively encouraging employees and consumers in the health care industry to report suspected fraud directly to government agencies or through “whistleblower” lawsuits. Balick & Balick attorneys have extensive experience representing health care providers in criminal, civil, and administrative matters arising under the False Claims Act, the Anti-Kickback Act, the Stark Act (which governs physician self-referrals), and related federal and state laws.

In these matters, we regularly assist clients in responding to civil investigative demands, search warrants, document subpoenas, and grand jury subpoenas; engage in discovery and trial preparation; and negotiate settlements and Corporate Integrity Agreements. As a former state prosecutor, Adam Balick understands the practical workings of, and is well-acquainted with the key staff in, the government offices investigating health care fraud and abuse in Delaware, including the Department of Justice, the United States Attorney’s Office, the state Medicaid Fraud Control Unit, and the Delaware Department of Insurance, which investigates alleged fraudulent billing brought to its attention by private health insurers.

Representative Matters:

Negotiated settlement of False Claims Act violations with the Department of Justice and with the Office of the Inspector General that permitted a nursing home to avoid being excluded from participating in the Medicare and Medicaid programs.

Represented a physician who was criminally charged with federal Health Care Fraud and Mail Fraud, stemming from the government’s allegations that the physician billed Medicare for diagnostic tests that were not performed.

Persuaded the State Medicaid Fraud Control Unit to drop a fraud investigation involving a large Delaware medical practice. The government had alleged that the practice engaged in improper payment arrangements with contracted physicians in order to induce referrals in violation of the state Anti-Kickback statute.

Successfully defended a principal of an ambulance company who had been charged with Medicare Fraud.

  • Navigating Delaware's Legal Landscape