Health Care Litigation

Healthcare providers operate in an environment wherein they are constantly susceptible to litigation. On a daily basis, healthcare providers are responsible for patient safety and quality of care. Any medical decision may result in an injury to a patient and, in turn, a lawsuit. Medical malpractice cases are complex and typically require specialized knowledge and expertise, including the effective use of medical expert witnesses.

In addition to medical malpractice, healthcare providers face substantial compliance-related litigation. Healthcare is one of the most highly regulated industries, with state and federal laws and regulations that govern nearly every aspect of a healthcare provider’s business. Healthcare providers face liability under the various federal and state laws and regulations that affect the healthcare industry. One of the primary areas for healthcare litigation is in the fraud and abuse arena. The Anti-Kickback Law prohibits the knowing offer, payment, solicitation, or receipt of anything of value in order to induce referrals. The Stark Law prohibits a physician from making a referral for designated healthcare services payable by Medicare or Medicaid to an entity in which it has a financial relationship. The False Claims Act prohibits a provider from submitting a claim for payment from a federal healthcare program for claims which were false, including claims for which there was an underlying Stark Law violation. False Claims lawsuits can be qui tam actions, meaning they can be brought by whistleblowers who are incentivized to bring claims because they keep a percentage of any damages awarded by the court.  These claims ay result in staggering civil money penalties and can be financially devastating for a provider.

Healthcare providers may also face disputes regarding reimbursement matters from federal healthcare programs or private payors that must be administratively or civilly litigated. Some providers may also pursue administrative appeals related to reimbursement rates from government payors.

The attorneys at MacDonald Illig have a sophisticated healthcare practice, representing providers of all sizes and types in a variety of healthcare matters. When healthcare litigation arises, MacDonald Illig’s healthcare attorneys partner with its litigation team to provide clients with knowledgeable and zealous advocacy. Our attorneys represent clients in administrative proceedings, arbitration, and in court by combining our expertise in the healthcare industry with a team of skilled litigators.